Provider Demographics
NPI:1245736354
Name:SACCO MARANDO, GINA (LMHC)
Entity Type:Individual
Prefix:MRS
First Name:GINA
Middle Name:
Last Name:SACCO MARANDO
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:MRS
Other - First Name:GINA
Other - Middle Name:
Other - Last Name:MARANDO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMHC
Mailing Address - Street 1:234 148TH ST
Mailing Address - Street 2:
Mailing Address - City:WHITESTONE
Mailing Address - State:NY
Mailing Address - Zip Code:11357-1121
Mailing Address - Country:US
Mailing Address - Phone:718-614-2795
Mailing Address - Fax:
Practice Address - Street 1:300 GARDEN CITY PLZ STE 304
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:NY
Practice Address - Zip Code:11530-3331
Practice Address - Country:US
Practice Address - Phone:516-399-1622
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-05
Last Update Date:2018-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008351-1101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY$$$$$$$$$OtherSOCIAL SECURITY