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General NPI Number Information
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NPI Number | 1417036609
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Entity Type | Individual
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Provider Name | CHRISTINE GATTUSO LCSW-R
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Gender | Female
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Dates
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Enumeration Date | 11/06/2006
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Last Update Date | 11/16/2020
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Provider Practice Location Address
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Address Line | 521 MAIN ST
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City | NEW PALTZ
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State | NY
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Zip | 12561-1609
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Country | US
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Telephone | 845-392-6670
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Fax | 845-795-5850
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Provider Business Mailing Address
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Address Line | 705 LATTINTOWN RD
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City | MILTON
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State | NY
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Zip | 12547-5311
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Country | US
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Telephone | 845-392-6670
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Fax | 845-795-5850
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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 | R059551-1
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License Number State | NY
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