Provider Demographics
NPI:1043782766
Name:PATTI, CORINE FRANCESCA (LMSW)
Entity Type:Individual
Prefix:MS
First Name:CORINE
Middle Name:FRANCESCA
Last Name:PATTI
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 1:15 WARREN CT
Mailing Address - Street 2:
Mailing Address - City:FARMINGVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11738-2287
Mailing Address - Country:US
Mailing Address - Phone:631-245-5058
Mailing Address - Fax:
Practice Address - Street 1:2075 NEW YORK AVE
Practice Address - Street 2:
Practice Address - City:HUNTINGTON STATION
Practice Address - State:NY
Practice Address - Zip Code:11746-3238
Practice Address - Country:US
Practice Address - Phone:631-351-7112
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-19
Last Update Date:2018-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY090471104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker