Provider Demographics
NPI:1609593755
Name:BATTINELLI, KADIJATU (MHC-LP)
Entity Type:Individual
Prefix:MS
First Name:KADIJATU
Middle Name:
Last Name:BATTINELLI
Suffix:
Gender:F
Credentials:MHC-LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 NORTHRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON STATION
Mailing Address - State:NY
Mailing Address - Zip Code:11746-1025
Mailing Address - Country:US
Mailing Address - Phone:516-680-7281
Mailing Address - Fax:
Practice Address - Street 1:15 NORTHRIDGE ST
Practice Address - Street 2:
Practice Address - City:HUNTINGTON STATION
Practice Address - State:NY
Practice Address - Zip Code:11746-1025
Practice Address - Country:US
Practice Address - Phone:516-680-7281
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-20
Last Update Date:2022-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP101156101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional