Provider Demographics
NPI:1518460708
Name:SPATARELLA, PAUL (LCSW)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:
Last Name:SPATARELLA
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:235 GARTH RD APT D3C
Mailing Address - Street 2:
Mailing Address - City:SCARSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10583-3949
Mailing Address - Country:US
Mailing Address - Phone:914-438-7162
Mailing Address - Fax:
Practice Address - Street 1:2778 3RD AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10455-4029
Practice Address - Country:US
Practice Address - Phone:718-402-9000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-14
Last Update Date:2018-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0738491041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical