Provider Demographics
NPI:1639508815
Name:PIETRONIRO, JESSE LEE (LCSW)
Entity Type:Individual
Prefix:
First Name:JESSE
Middle Name:LEE
Last Name:PIETRONIRO
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 1:63 SUNNYSIDE PL
Mailing Address - Street 2:
Mailing Address - City:IRVINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:10533-1338
Mailing Address - Country:US
Mailing Address - Phone:413-209-0487
Mailing Address - Fax:
Practice Address - Street 1:63 SUNNYSIDE PL
Practice Address - Street 2:
Practice Address - City:IRVINGTON
Practice Address - State:NY
Practice Address - Zip Code:10533-1338
Practice Address - Country:US
Practice Address - Phone:413-209-0487
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-07
Last Update Date:2021-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0851501041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical