Provider Demographics
NPI:1497934152
Name:SCOPELLITI-MASTRANDREA, MARGARET (LCSW-R)
Entity Type:Individual
Prefix:MRS
First Name:MARGARET
Middle Name:
Last Name:SCOPELLITI-MASTRANDREA
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 1:2800 MORTON AVE
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11572-2346
Mailing Address - Country:US
Mailing Address - Phone:516-297-1856
Mailing Address - Fax:516-766-7415
Practice Address - Street 1:2800 MORTON AVE
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:NY
Practice Address - Zip Code:11572-2346
Practice Address - Country:US
Practice Address - Phone:516-297-1856
Practice Address - Fax:516-766-7415
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-30
Last Update Date:2015-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0491651041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA300119918Medicare PIN
NYG300207918Medicare PIN