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NPI 1487935169

NPI 1487935169 : MICHAEL J. STANET LCSW-R : MOUNT KISCO, NY

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General NPI Number Information
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    NPI Number           |    1487935169
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    Entity Type          |    Individual 
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    Provider Name        |    MICHAEL J. STANET LCSW-R
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    09/08/2011
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    Last Update Date     |    09/08/2011
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Provider Practice Location Address
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    Address Line         |    239 LEXINGTON AVE 
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    City                 |    MOUNT KISCO
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    State                |    NY
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    Zip                  |    10549-2780
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    Country              |    US
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    Telephone            |    845-625-3945
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    3605 CHELSEA CV S 
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    City                 |    HOPEWELL JUNCTION
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    State                |    NY
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    Zip                  |    12533-6935
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    Country              |    US
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    Telephone            |    845-625-3945
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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       |    077910
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    License Number State |    NY
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