Provider Demographics
NPI:1043785629
Name:DICICCO-HANLEY, JUNE ELLEN (LCSW-R)
Entity Type:Individual
Prefix:
First Name:JUNE
Middle Name:ELLEN
Last Name:DICICCO-HANLEY
Suffix:
Gender:F
Credentials:LCSW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 NEPERA PL
Mailing Address - Street 2:
Mailing Address - City:HASTINGS ON HUDSON
Mailing Address - State:NY
Mailing Address - Zip Code:10706-3604
Mailing Address - Country:US
Mailing Address - Phone:914-406-0811
Mailing Address - Fax:
Practice Address - Street 1:7 NEPERA PL
Practice Address - Street 2:
Practice Address - City:HASTINGS ON HUDSON
Practice Address - State:NY
Practice Address - Zip Code:10706-3604
Practice Address - Country:US
Practice Address - Phone:914-406-0811
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-10
Last Update Date:2018-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR076072-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical