Provider Demographics
NPI:1316416498
Name:ZAMBITO, JACQUELINE MARIE (LMHC)
Entity Type:Individual
Prefix:
First Name:JACQUELINE
Middle Name:MARIE
Last Name:ZAMBITO
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:419 LIDO PKWY
Mailing Address - Street 2:
Mailing Address - City:LINDENHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11757-6318
Mailing Address - Country:US
Mailing Address - Phone:631-559-0807
Mailing Address - Fax:631-956-0252
Practice Address - Street 1:100 DUFFY AVE STE 510
Practice Address - Street 2:
Practice Address - City:HICKSVILLE
Practice Address - State:NY
Practice Address - Zip Code:11801-3636
Practice Address - Country:US
Practice Address - Phone:631-533-3763
Practice Address - Fax:631-956-0252
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-18
Last Update Date:2020-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008964101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health