MEDICARE: PRISKA IMBERTI LCSW

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	075579-1	NY
2	1041S0200X	School Social Worker		NY

General Provider Information

NPI Number	:	1831309715
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PRISKA IMBERTI LCSW

Provider Business Mailing Address
First Line	:	1335 3RD ST
Second Line	:
City	:	WEST BABYLON
State	:	NY
Zip	:	11704-4729
Country	:	US
Telephone Number	:	631-888-0215
Fax Number	:	631-888-0431

Provider Business Practice Location Address
First Line	:	72 GUY LOMBARDO AVE
Second Line	:	SUITE # 2
City	:	FREEPORT
State	:	NY
Zip	:	11520-3742
Country	:	US
Telephone Number	:	516-623-2162
Fax Number	:

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

Provider Enumeration Date	:	05/22/2007
Last Update Date	:	09/11/2025

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Directions to “ PRISKA IMBERTI LCSW” Practice Location

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