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NPI 1689149403

NPI 1689149403 : DIPAOLA PSYCHOTHERAPY LCSW PLLC : ROCKVILLE CENTRE, NY

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General NPI Number Information
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    NPI Number           |    1689149403
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    Entity Type          |    Organization 
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    Legal Business Name  |    DIPAOLA PSYCHOTHERAPY LCSW PLLC 
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Dates
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    Enumeration Date     |    10/08/2018
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    Last Update Date     |    10/08/2018
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Provider Practice Location Address
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    Address Line         |    55 FRONT ST STE 10 
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    City                 |    ROCKVILLE CENTRE
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    State                |    NY
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    Zip                  |    11570-4040
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    Country              |    US
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    Telephone            |    908-692-0925
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    55 FRONT ST STE 10 
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    City                 |    ROCKVILLE CENTRE
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    State                |    NY
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    Zip                  |    11570-4040
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    Country              |    US
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    Telephone            |    908-692-0925
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    Fax                  |    
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Authorized Official
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    Title or Position    |    CEO
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    Name                 |    MRS. CAROL  DIPAOLA 
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    Credential           |    LSCW
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    Telephone            |    908-692-0925
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    261QM0801X
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    Taxonomy Name        |    Mental Health Clinic/Center (Including Community Mental Health Center)
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    License Number       |    
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    License Number State |    
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