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NPI 1437962180

NPI 1437962180 : MARCONI INTEGRATIVE THERAPY, LCSW PLLC : EAST NORTHPORT, NY

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General NPI Number Information
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    NPI Number           |    1437962180
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    Entity Type          |    Organization 
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    Legal Business Name  |    MARCONI INTEGRATIVE THERAPY, LCSW PLLC 
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Dates
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    Enumeration Date     |    01/28/2025
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    Last Update Date     |    02/07/2025
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Provider Practice Location Address
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    Address Line         |    511 PULASKI RD APT SUITE 
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    City                 |    EAST NORTHPORT
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    State                |    NY
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    Zip                  |    11731-2139
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    Country              |    US
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    Telephone            |    631-455-1884
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    511 PULASKI RD APT SUITE 
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    City                 |    EAST NORTHPORT
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    State                |    NY
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    Zip                  |    11731-2139
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    Country              |    US
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    Telephone            |    631-455-1884
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    Fax                  |    
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |    MS. MELISSA  MARCONI 
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    Credential           |    LCSW
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    Telephone            |    800-426-6937
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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       |    
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    License Number State |    
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