Provider Demographics
NPI:1629118880
Name:ALESSANDRO, MARIA A (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:A
Last Name:ALESSANDRO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 SPRINGDALE DR
Mailing Address - Street 2:
Mailing Address - City:RONKONKOMA
Mailing Address - State:NY
Mailing Address - Zip Code:11779-5933
Mailing Address - Country:US
Mailing Address - Phone:631-838-1973
Mailing Address - Fax:
Practice Address - Street 1:115 SPRINGDALE DR
Practice Address - Street 2:
Practice Address - City:RONKONKOMA
Practice Address - State:NY
Practice Address - Zip Code:11779-5933
Practice Address - Country:US
Practice Address - Phone:631-838-1973
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-07
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY069420-1101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor