Healthcare Provider Details

I. General information

NPI: 1447538483
Provider Name (Legal Business Name): CHRISTINE ANN CINCOTTA LMFT, CASAC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/25/2011
Last Update Date: 07/25/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 CATHY CT
WALLKILL NY
12589-4213
US

IV. Provider business mailing address

6 CATHY CT
WALLKILL NY
12589-4213
US

V. Phone/Fax

Practice location:
  • Phone: 845-938-7691
  • Fax: 845-938-5770
Mailing address:
  • Phone: 845-938-7691
  • Fax: 845-938-5770

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number21661
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number000814
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: