Provider Demographics
NPI:1407359797
Name:MARCHESANO, KIRSTEN (LCSW)
Entity Type:Individual
Prefix:
First Name:KIRSTEN
Middle Name:
Last Name:MARCHESANO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:165 TODD RD
Mailing Address - Street 2:
Mailing Address - City:KATONAH
Mailing Address - State:NY
Mailing Address - Zip Code:10536-2512
Mailing Address - Country:US
Mailing Address - Phone:917-886-1919
Mailing Address - Fax:
Practice Address - Street 1:455 CENTRAL PARK AVE STE 206
Practice Address - Street 2:
Practice Address - City:SCARSDALE
Practice Address - State:NY
Practice Address - Zip Code:10583-1034
Practice Address - Country:US
Practice Address - Phone:917-886-1919
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-13
Last Update Date:2023-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY071226-1101YM0800X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY071226-1OtherLCSW
NY071226-1OtherNYS LICENSE