Provider Demographics
NPI:1659773356
Name:MONTIFIORE, CATHERINE CORDELL (LCSW, CASAC)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:CORDELL
Last Name:MONTIFIORE
Suffix:
Gender:F
Credentials:LCSW, CASAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:261 BROADWAY
Mailing Address - Street 2:APT 12B
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10007-2305
Mailing Address - Country:US
Mailing Address - Phone:917-922-1007
Mailing Address - Fax:
Practice Address - Street 1:17 6TH AVE
Practice Address - Street 2:2A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10013-5717
Practice Address - Country:US
Practice Address - Phone:917-922-1007
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-24
Last Update Date:2017-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY26651101YA0400X
NY082254-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)