Provider Demographics
NPI:1609984160
Name:PACI, VITTORIO (LCSW)
Entity Type:Individual
Prefix:MR
First Name:VITTORIO
Middle Name:
Last Name:PACI
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:275 WEST 96 STREET
Mailing Address - Street 2:#27B
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-6263
Mailing Address - Country:US
Mailing Address - Phone:212-865-5993
Mailing Address - Fax:
Practice Address - Street 1:275 W 96TH ST
Practice Address - Street 2:#27B
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-6200
Practice Address - Country:US
Practice Address - Phone:212-865-5993
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-26
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY072441-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYNC1741Medicare ID - Type UnspecifiedLICENCED CLINICAL SOCIAL