Provider Demographics
NPI:1154489854
Name:CATALANO, JEANNINE (LCSW)
Entity Type:Individual
Prefix:
First Name:JEANNINE
Middle Name:
Last Name:CATALANO
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 1:34 ATLANTIC AVE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:LYNBROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11563-3038
Mailing Address - Country:US
Mailing Address - Phone:516-528-0452
Mailing Address - Fax:516-528-0452
Practice Address - Street 1:126 N FRANKLIN STREET
Practice Address - Street 2:
Practice Address - City:HEMPSTEAD
Practice Address - State:NY
Practice Address - Zip Code:11550-1318
Practice Address - Country:US
Practice Address - Phone:516-528-0452
Practice Address - Fax:516-528-0452
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-05
Last Update Date:2010-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR054765-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02722278Medicaid
NYP759556OtherOXFORD
NYP759556OtherOXFORD