Healthcare Provider Details

I. General information

NPI: 1356611792
Provider Name (Legal Business Name): DENISE MARIE GUERRIERO LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/03/2012
Last Update Date: 01/03/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14 COLD SPRING LN
NEWBURGH NY
12550-8785
US

IV. Provider business mailing address

14 COLD SPRING LN
NEWBURGH NY
12550-8785
US

V. Phone/Fax

Practice location:
  • Phone: 845-926-8280
  • Fax:
Mailing address:
  • Phone: 845-926-8280
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number074512-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: