Provider Demographics
NPI:1013564327
Name:MONACO, CRYSTAL J (LMSW)
Entity Type:Individual
Prefix:
First Name:CRYSTAL
Middle Name:J
Last Name:MONACO
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 STARLIGHT LN
Mailing Address - Street 2:
Mailing Address - City:LEVITTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:11756-4426
Mailing Address - Country:US
Mailing Address - Phone:516-362-8249
Mailing Address - Fax:
Practice Address - Street 1:400 S OYSTER BAY RD STE 102
Practice Address - Street 2:
Practice Address - City:HICKSVILLE
Practice Address - State:NY
Practice Address - Zip Code:11801-3500
Practice Address - Country:US
Practice Address - Phone:516-818-8383
Practice Address - Fax:516-605-1181
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-21
Last Update Date:2019-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY107126104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty