Provider Demographics
NPI:1689353203
Name:VICARI, JULIET
Entity Type:Individual
Prefix:
First Name:JULIET
Middle Name:
Last Name:VICARI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:351 MANVILLE RD STE 104
Mailing Address - Street 2:
Mailing Address - City:PLEASANTVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:10570-2166
Mailing Address - Country:US
Mailing Address - Phone:914-448-4343
Mailing Address - Fax:
Practice Address - Street 1:351 MANVILLE RD STE 104
Practice Address - Street 2:
Practice Address - City:PLEASANTVILLE
Practice Address - State:NY
Practice Address - Zip Code:10570-2166
Practice Address - Country:US
Practice Address - Phone:914-488-4343
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-12
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY120189104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker