Provider Demographics
NPI:1518997055
Name:RANGE, JOANNE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:JOANNE
Middle Name:
Last Name:RANGE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:JOANNE
Other - Middle Name:
Other - Last Name:ROBERTS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:116-35 218TH STREET CAMBRIA HEIGHTS
Mailing Address - Street 2:
Mailing Address - City:QUEENS
Mailing Address - State:NY
Mailing Address - Zip Code:11411
Mailing Address - Country:US
Mailing Address - Phone:718-730-0139
Mailing Address - Fax:
Practice Address - Street 1:11635 218TH ST
Practice Address - Street 2:
Practice Address - City:CAMBRIA HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11411-1503
Practice Address - Country:US
Practice Address - Phone:718-730-0139
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2020-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0233451041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical