Provider Demographics
NPI:1104021955
Name:FRATTO, VINCENT NONE (LCSW)
Entity Type:Individual
Prefix:MR
First Name:VINCENT
Middle Name:NONE
Last Name:FRATTO
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:747 COUNTY ROUTE 49
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10940-6878
Mailing Address - Country:US
Mailing Address - Phone:845-343-3138
Mailing Address - Fax:845-343-3138
Practice Address - Street 1:747 COUNTY ROUTE 49
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:NY
Practice Address - Zip Code:10940-6878
Practice Address - Country:US
Practice Address - Phone:845-343-3138
Practice Address - Fax:845-343-3138
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPR-026206-1102L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst