Provider Demographics
NPI:1609120732
Name:CALISI, JAMES M (MA, NCSP)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:M
Last Name:CALISI
Suffix:
Gender:M
Credentials:MA, NCSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 ROMAN ACRES DR
Mailing Address - Street 2:
Mailing Address - City:GARNERVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:10923-1112
Mailing Address - Country:US
Mailing Address - Phone:845-429-8669
Mailing Address - Fax:
Practice Address - Street 1:664 ORANGEBURG RD
Practice Address - Street 2:
Practice Address - City:PEARL RIVER
Practice Address - State:NY
Practice Address - Zip Code:10965-2830
Practice Address - Country:US
Practice Address - Phone:845-735-3066
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-26
Last Update Date:2012-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool