Provider Demographics
NPI:1326184441
Name:LODATO-MAGUIRE, CHRISTINE (LCSW-R)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:LODATO-MAGUIRE
Suffix:
Gender:F
Credentials:LCSW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 N RICHMOND AVE
Mailing Address - Street 2:
Mailing Address - City:MASSAPEQUA
Mailing Address - State:NY
Mailing Address - Zip Code:11758-3439
Mailing Address - Country:US
Mailing Address - Phone:516-799-2389
Mailing Address - Fax:516-798-5320
Practice Address - Street 1:121 N RICHMOND AVE
Practice Address - Street 2:
Practice Address - City:MASSAPEQUA
Practice Address - State:NY
Practice Address - Zip Code:11758-3439
Practice Address - Country:US
Practice Address - Phone:516-799-2389
Practice Address - Fax:516-798-5320
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR044895-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical