Provider Demographics
NPI:1457451163
Name:MUSCENTE, MARIA ANN (LCSW-R)
Entity Type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:ANN
Last Name:MUSCENTE
Suffix:
Gender:F
Credentials:LCSW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 W COURT ST STE 101
Mailing Address - Street 2:
Mailing Address - City:ITHACA
Mailing Address - State:NY
Mailing Address - Zip Code:14850-4105
Mailing Address - Country:US
Mailing Address - Phone:607-351-1562
Mailing Address - Fax:
Practice Address - Street 1:121 W COURT ST STE 101
Practice Address - Street 2:
Practice Address - City:ITHACA
Practice Address - State:NY
Practice Address - Zip Code:14850-4105
Practice Address - Country:US
Practice Address - Phone:607-351-1562
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-23
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY053368-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical