Provider Demographics
NPI:1578035234
Name:SIGNORELLI, BIANCA (LMSW)
Entity Type:Individual
Prefix:
First Name:BIANCA
Middle Name:
Last Name:SIGNORELLI
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 1:9 VANDERBILT AVE
Mailing Address - Street 2:
Mailing Address - City:BABYLON
Mailing Address - State:NY
Mailing Address - Zip Code:11704-7318
Mailing Address - Country:US
Mailing Address - Phone:516-974-3684
Mailing Address - Fax:
Practice Address - Street 1:28 MERRICK AVE STE 9
Practice Address - Street 2:
Practice Address - City:MERRICK
Practice Address - State:NY
Practice Address - Zip Code:11566-3433
Practice Address - Country:US
Practice Address - Phone:516-580-1975
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-19
Last Update Date:2018-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY105282104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker