Provider Demographics
NPI:1407153752
Name:DI PAOLA, PETER C (LMSW)
Entity Type:Individual
Prefix:MR
First Name:PETER
Middle Name:C
Last Name:DI PAOLA
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:365 BARLOW AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10308-1301
Mailing Address - Country:US
Mailing Address - Phone:718-974-2066
Mailing Address - Fax:
Practice Address - Street 1:365 BARLOW AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10308-1301
Practice Address - Country:US
Practice Address - Phone:718-974-2066
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-23
Last Update Date:2023-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0701281041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical