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General NPI Number Information
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NPI Number | 1396376679
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Entity Type | Individual
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Provider Name | ANDREA JEAN CILENTO LCSW
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Gender | Female
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Dates
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Enumeration Date | 01/27/2020
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Last Update Date | 01/27/2020
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Provider Practice Location Address
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Address Line | 115 E 57TH ST STE 640
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City | NEW YORK
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State | NY
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Zip | 10022-2392
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Country | US
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Telephone | 917-943-1647
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Fax |
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Provider Business Mailing Address
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Address Line | 2243 47TH ST
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City | ASTORIA
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State | NY
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Zip | 11105-1309
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Country | US
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Telephone | 206-427-8633
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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 | 089063
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License Number State | NY
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