Healthcare Provider Details

I. General information

NPI: 1386493021
Provider Name (Legal Business Name): DANIELLE SANGIOVANNI LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/15/2024
Last Update Date: 05/15/2024
Certification Date: 05/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

90 W MAIN ST
PATCHOGUE NY
11772-3043
US

IV. Provider business mailing address

9 DONALD CT E
BLUE POINT NY
11715-2305
US

V. Phone/Fax

Practice location:
  • Phone: 631-879-3204
  • Fax:
Mailing address:
  • Phone: 631-879-3204
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number097525-01
License Number StateNY

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: