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General NPI Number Information
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NPI Number | 1003915547
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Entity Type | Individual
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Provider Name | VINCENT PISHIONERI LCSW
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Gender | Male
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Dates
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Enumeration Date | 09/21/2006
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 860 KEMPSVILLE RD THE PINES RTC
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City | NORFOLK
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State | VA
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Zip | 23502-3920
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Country | US
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Telephone | 757-461-4565
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Fax |
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Provider Business Mailing Address
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Address Line | 5777 LANCELOT DR
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City | VIRGINIA BEACH
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State | VA
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Zip | 23464-2249
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Country | US
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Telephone | 757-420-1858
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 0904000248
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License Number State | VA
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