Provider Demographics
NPI:1548566482
Name:VISCARDI, MARIE (LMSW)
Entity Type:Individual
Prefix:
First Name:MARIE
Middle Name:
Last Name:VISCARDI
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37 JOHN ST
Mailing Address - Street 2:
Mailing Address - City:AMITYVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11701-2930
Mailing Address - Country:US
Mailing Address - Phone:631-424-2900
Mailing Address - Fax:631-598-5716
Practice Address - Street 1:37 JOHN ST
Practice Address - Street 2:
Practice Address - City:AMITYVILLE
Practice Address - State:NY
Practice Address - Zip Code:11701-2930
Practice Address - Country:US
Practice Address - Phone:631-424-2900
Practice Address - Fax:631-598-5716
Is Sole Proprietor?:No
Enumeration Date:2011-02-09
Last Update Date:2011-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY082227104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker