Provider Demographics
NPI:1245595800
Name:RIZZOTTO, LINDA D (LCSW)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:D
Last Name:RIZZOTTO
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 1:1492 RICHMOND ROAD
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10304-2319
Mailing Address - Country:US
Mailing Address - Phone:718-648-9387
Mailing Address - Fax:
Practice Address - Street 1:308 SEAVIEW AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10305-2246
Practice Address - Country:US
Practice Address - Phone:718-351-1717
Practice Address - Fax:718-667-8893
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-10
Last Update Date:2018-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0553681041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical