Provider Demographics
NPI:1609927177
Name:PESTANO, ANNE M (LMHC)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:M
Last Name:PESTANO
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 390
Mailing Address - Street 2:
Mailing Address - City:CORNWALL
Mailing Address - State:NY
Mailing Address - Zip Code:12518-0390
Mailing Address - Country:US
Mailing Address - Phone:917-332-7411
Mailing Address - Fax:
Practice Address - Street 1:31 LEXINGTON LN
Practice Address - Street 2:
Practice Address - City:NEW WINDSOR
Practice Address - State:NY
Practice Address - Zip Code:12553-7531
Practice Address - Country:US
Practice Address - Phone:845-440-1872
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000434101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health