Provider Demographics
NPI:1437737624
Name:MOCCIA, ANNETTE (LMHC)
Entity Type:Individual
Prefix:
First Name:ANNETTE
Middle Name:
Last Name:MOCCIA
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 GREENE AVE STE 204
Mailing Address - Street 2:
Mailing Address - City:AMITYVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11701-2943
Mailing Address - Country:US
Mailing Address - Phone:516-743-8571
Mailing Address - Fax:
Practice Address - Street 1:21 GREENE AVE STE 204
Practice Address - Street 2:
Practice Address - City:AMITYVILLE
Practice Address - State:NY
Practice Address - Zip Code:11701-2943
Practice Address - Country:US
Practice Address - Phone:516-743-8571
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-30
Last Update Date:2021-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000082101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health