MEDICARE: MS. JOANNE M D'ONOFRIO LMHC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	000487	NY

General Provider Information

NPI Number	:	1023133758
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JOANNE M D'ONOFRIO LMHC

Provider Business Mailing Address
First Line	:	74 DENT RD
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10308-2952
Country	:	US
Telephone Number	:	718-967-1249
Fax Number	:

Provider Business Practice Location Address
First Line	:	74 DENT RD
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10308-2952
Country	:	US
Telephone Number	:	718-967-1249
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/20/2007
Last Update Date	:	07/08/2007

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