Provider Demographics
NPI:1063003879
Name:DALESSIO, ANN MARIE NANCY (LCSW)
Entity Type:Individual
Prefix:
First Name:ANN MARIE
Middle Name:NANCY
Last Name:DALESSIO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 JUNIPER RD
Mailing Address - Street 2:
Mailing Address - City:ROCKY POINT
Mailing Address - State:NY
Mailing Address - Zip Code:11778-8744
Mailing Address - Country:US
Mailing Address - Phone:631-456-3950
Mailing Address - Fax:
Practice Address - Street 1:16 JUNIPER RD
Practice Address - Street 2:
Practice Address - City:ROCKY POINT
Practice Address - State:NY
Practice Address - Zip Code:11778-8744
Practice Address - Country:US
Practice Address - Phone:631-456-3950
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-03
Last Update Date:2023-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY105362101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health