Provider Demographics
NPI:1558751024
Name:LOPICCOLO, SALVATRICE (MS)
Entity Type:Individual
Prefix:
First Name:SALVATRICE
Middle Name:
Last Name:LOPICCOLO
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 WASHINGTON AVENUE EXT
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12203-7303
Mailing Address - Country:US
Mailing Address - Phone:518-392-7314
Mailing Address - Fax:518-862-2175
Practice Address - Street 1:300 WASHINGTON AVENUE EXT
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12203-7303
Practice Address - Country:US
Practice Address - Phone:518-392-7314
Practice Address - Fax:518-862-2175
Is Sole Proprietor?:No
Enumeration Date:2015-02-04
Last Update Date:2015-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006387-1101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health