Provider Demographics
NPI:1437334190
Name:MCFALL, LORISSA W (LCSWR)
Entity Type:Individual
Prefix:MS
First Name:LORISSA
Middle Name:W
Last Name:MCFALL
Suffix:
Gender:F
Credentials:LCSWR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2255 CENTRE AVE STE 2
Mailing Address - Street 2:
Mailing Address - City:BELLMORE
Mailing Address - State:NY
Mailing Address - Zip Code:11710-3499
Mailing Address - Country:US
Mailing Address - Phone:516-882-4544
Mailing Address - Fax:
Practice Address - Street 1:2255 CENTRE AVE STE 2
Practice Address - Street 2:
Practice Address - City:BELLMORE
Practice Address - State:NY
Practice Address - Zip Code:11710-3499
Practice Address - Country:US
Practice Address - Phone:516-882-4544
Practice Address - Fax:516-880-9515
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-31
Last Update Date:2021-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY076394-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical