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General NPI Number Information
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NPI Number | 1659566099
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Entity Type | Individual
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Provider Name | JOAN DEGREGORIO LCSW, ACSW
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Gender | Female
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Dates
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Enumeration Date | 09/10/2007
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Last Update Date | 09/10/2007
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Provider Practice Location Address
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Address Line | 601 - 79 STREET STE. 1G
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City | BROOKLYN
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State | NY
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Zip | 11209-3755
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Country | US
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Telephone | 718-680-5468
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Fax | 212-317-1108
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Provider Business Mailing Address
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Address Line | 60 SUTTON PL S APT. 3FS
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City | NEW YORK
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State | NY
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Zip | 10022-4168
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Country | US
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Telephone | 212-317-1103
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Fax | 212-317-1108
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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 | R034551
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License Number State | NY
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