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General NPI Number Information
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NPI Number | 1841939493
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Entity Type | Individual
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Provider Name | MARIANA MICHEL GUERCIO LMSW
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Gender | Female
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Dates
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Enumeration Date | 06/01/2022
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Last Update Date | 02/13/2024
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Provider Practice Location Address
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Address Line | 811 W JERICHO TPKE STE 106E
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City | SMITHTOWN
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State | NY
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Zip | 11787-3220
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Country | US
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Telephone | 631-644-5876
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Fax |
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Provider Business Mailing Address
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Address Line | 44 9TH AVE
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City | KINGS PARK
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State | NY
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Zip | 11754-4315
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Country | US
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Telephone | 631-560-9726
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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Taxonomy #2
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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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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 117369
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License Number State | NY
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