Healthcare Provider Details

I. General information

NPI: 1164582995
Provider Name (Legal Business Name): GIOVANNA L ROVETTO-DEAN LCSW-R
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/11/2006
Last Update Date: 07/04/2025
Certification Date: 07/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

527 BAY RD STE 105
QUEENSBURY NY
12804-1430
US

IV. Provider business mailing address

527 BAY RD STE 105
QUEENSBURY NY
12804-1430
US

V. Phone/Fax

Practice location:
  • Phone: 518-223-0552
  • Fax: 518-223-0513
Mailing address:
  • Phone: 518-223-0552
  • Fax: 518-223-0513

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberR048485
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: