Healthcare Provider Details

I. General information

NPI: 1982899779
Provider Name (Legal Business Name): LUCY MARIE NOTARO LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/13/2007
Last Update Date: 09/19/2026
Certification Date: 09/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

99 MAIN ST
NYACK NY
10960-3109
US

IV. Provider business mailing address

10 PETTY LN
MEDFORD NY
11763-2630
US

V. Phone/Fax

Practice location:
  • Phone: 516-473-3580
  • Fax: 516-473-3580
Mailing address:
  • Phone: 516-473-3580
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number099266
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: