Provider Demographics
NPI:1518990811
Name:CALCAGNINO, DENISE MICHELLE (LCSW-R, CASAC)
Entity Type:Individual
Prefix:MS
First Name:DENISE
Middle Name:MICHELLE
Last Name:CALCAGNINO
Suffix:
Gender:F
Credentials:LCSW-R, CASAC
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Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:6215 KENLAREN CIR
Mailing Address - Street 2:
Mailing Address - City:NORTH SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13212-1867
Mailing Address - Country:US
Mailing Address - Phone:315-454-9433
Mailing Address - Fax:
Practice Address - Street 1:VETERANS MEMORIAL BUILDING
Practice Address - Street 2:NORTH COURT STREET
Practice Address - City:WAMPSVILLE
Practice Address - State:NY
Practice Address - Zip Code:13163
Practice Address - Country:US
Practice Address - Phone:315-366-2232
Practice Address - Fax:315-366-2599
Is Sole Proprietor?:No
Enumeration Date:2006-07-09
Last Update Date:2022-12-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY11596101YA0400X
NY756241041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)