Provider Demographics
NPI:1144467929
Name:MARY ALICE ORITO PSYCHOTHERAPY LICENSED CLINICAL SOCIAL WORK PLLC
Entity type:Organization
Organization Name:MARY ALICE ORITO PSYCHOTHERAPY LICENSED CLINICAL SOCIAL WORK PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:ALICE
Authorized Official - Last Name:ORITO
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, CASAC, CADC
Authorized Official - Phone:212-260-9085
Mailing Address - Street 1:330 1ST AVE
Mailing Address - Street 2:3E
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10009-1701
Mailing Address - Country:US
Mailing Address - Phone:212-260-9085
Mailing Address - Fax:
Practice Address - Street 1:85 5TH AVE
Practice Address - Street 2:927
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-3019
Practice Address - Country:US
Practice Address - Phone:917-549-8996
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-15
Last Update Date:2009-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0535011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty