MEDICARE: MRS. LINDA IACURTO MA, ATR-BC, LCAT

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	000677-1	NY

General Provider Information

NPI Number	:	1881864478
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LINDA IACURTO MA, ATR-BC, LCAT

Provider Business Mailing Address
First Line	:	174 TALLMAN ST
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10312-4816
Country	:	US
Telephone Number	:	718-984-5444
Fax Number	:	718-317-9538

Provider Business Practice Location Address
First Line	:	174 TALLMAN ST
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10312-4816
Country	:	US
Telephone Number	:	718-984-5444
Fax Number	:	718-317-9538

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

Provider Enumeration Date	:	03/10/2008
Last Update Date	:	05/26/2021

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