Provider Demographics
NPI:1619392263
Name:ZITO, KAELA (LMSW)
Entity Type:Individual
Prefix:
First Name:KAELA
Middle Name:
Last Name:ZITO
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:KAELA
Other - Middle Name:
Other - Last Name:LAKOWITZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:22110 JAMAICA AVE
Mailing Address - Street 2:
Mailing Address - City:QUEENS VILLAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11428-2045
Mailing Address - Country:US
Mailing Address - Phone:718-468-4700
Mailing Address - Fax:
Practice Address - Street 1:22110 JAMAICA AVE
Practice Address - Street 2:
Practice Address - City:QUEENS VILLAGE
Practice Address - State:NY
Practice Address - Zip Code:11428-2045
Practice Address - Country:US
Practice Address - Phone:718-468-4700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-19
Last Update Date:2014-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker