Provider Demographics
NPI:1164993531
Name:GENAU, GIANNCI (LMSW)
Entity Type:Individual
Prefix:
First Name:GIANNCI
Middle Name:
Last Name:GENAU
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13640 STATE ROUTE 22
Mailing Address - Street 2:
Mailing Address - City:CANAAN
Mailing Address - State:NY
Mailing Address - Zip Code:12029-3506
Mailing Address - Country:US
Mailing Address - Phone:845-239-2076
Mailing Address - Fax:845-262-4694
Practice Address - Street 1:45 DOLSON AVE STE 4
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:NY
Practice Address - Zip Code:10940-6462
Practice Address - Country:US
Practice Address - Phone:845-239-2076
Practice Address - Fax:845-262-4694
Is Sole Proprietor?:No
Enumeration Date:2018-12-11
Last Update Date:2021-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker