MEDICARE: ALLEGRO PSYCHOTHERAPY

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

General Provider Information

NPI Number	:	1962256065
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALLEGRO PSYCHOTHERAPY

Provider Business Mailing Address
First Line	:	28 WASHINGTON AVE
Second Line	:
City	:	SMITHTOWN
State	:	NY
Zip	:	11787-5525
Country	:	US
Telephone Number	:	516-243-7909
Fax Number	:

Provider Business Practice Location Address
First Line	:	28 WASHINGTON AVE
Second Line	:
City	:	SMITHTOWN
State	:	NY
Zip	:	11787-5525
Country	:	US
Telephone Number	:	516-243-7909
Fax Number	:

Authorized Official
Title or Position	:	COUNSELOR - MENTAL HEALTH
Name	:	DEANA ROSE BOLOGNA
Credential	:	OWNER
Telephone Number	:	516-243-7909

Provider Enumeration Date	:	04/15/2024
Last Update Date	:	04/15/2024

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Directions to “ALLEGRO PSYCHOTHERAPY ” Practice Location

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