Provider Demographics
NPI:1376243337
Name:VERALLI-GUTMANN, IRENE MICHELE (LMSW)
Entity Type:Individual
Prefix:MS
First Name:IRENE
Middle Name:MICHELE
Last Name:VERALLI-GUTMANN
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 1:260 MADISON AVE FL 8
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-2418
Mailing Address - Country:US
Mailing Address - Phone:387-589-8342
Mailing Address - Fax:
Practice Address - Street 1:260 MADISON AVE FL 8
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-2418
Practice Address - Country:US
Practice Address - Phone:387-589-8342
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-08
Last Update Date:2023-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0325201041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical