Provider Demographics
NPI:1659566099
Name:DEGREGORIO, JOAN (LCSW, ACSW)
Entity Type:Individual
Prefix:MRS
First Name:JOAN
Middle Name:
Last Name:DEGREGORIO
Suffix:
Gender:F
Credentials:LCSW, ACSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 SUTTON PL S
Mailing Address - Street 2:APT. 3FS
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-4168
Mailing Address - Country:US
Mailing Address - Phone:212-317-1103
Mailing Address - Fax:212-317-1108
Practice Address - Street 1:601 - 79 STREET
Practice Address - Street 2:STE. 1G
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209-3755
Practice Address - Country:US
Practice Address - Phone:718-680-5468
Practice Address - Fax:212-317-1108
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-10
Last Update Date:2007-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0345511041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical