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General NPI Number Information
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NPI Number | 1598807323
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Entity Type | Individual
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Provider Name | CATHERINE ANN BALLETTO LICSW
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Gender | Female
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Dates
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Enumeration Date | 02/12/2007
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Last Update Date | 04/25/2008
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Provider Practice Location Address
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Address Line | 80 E 11TH ST SUITE #321
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City | NEW YORK
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State | NY
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Zip | 10003-6811
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Country | US
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Telephone | 212-477-7977
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1502
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City | NORTHAMPTON
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State | MA
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Zip | 01061-1502
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Country | US
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Telephone | 413-341-3879
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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 | R042166
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License Number State | NY
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