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General NPI Number Information
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NPI Number | 1316416498
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Entity Type | Individual
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Provider Name | JACQUELINE MARIE ZAMBITO LMHC
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Gender | Female
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Dates
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Enumeration Date | 11/18/2018
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Last Update Date | 03/30/2020
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Provider Practice Location Address
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Address Line | 100 DUFFY AVE STE 510
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City | HICKSVILLE
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State | NY
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Zip | 11801-3636
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Country | US
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Telephone | 631-533-3763
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Fax | 631-956-0252
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Provider Business Mailing Address
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Address Line | 419 LIDO PKWY
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City | LINDENHURST
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State | NY
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Zip | 11757-6318
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Country | US
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Telephone | 631-559-0807
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Fax | 631-956-0252
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 008964
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License Number State | NY
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