MEDICARE: LORENZA PELLLICIOLI LMSW

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	1041C0700X	Clinical Social Worker	102440	NY
2	104100000X	Social Worker	112340-01	NY

General Provider Information

NPI Number	:	1548906670
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LORENZA PELLLICIOLI LMSW

Provider Business Mailing Address
First Line	:	462 1ST AVE
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10016
Country	:	US
Telephone Number	:	212-562-8950
Fax Number	:

Provider Business Practice Location Address
First Line	:	462 1ST AVE
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10016-9196
Country	:	US
Telephone Number	:	212-562-4141
Fax Number	:

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

Provider Enumeration Date	:	05/11/2022
Last Update Date	:	03/19/2026

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