Provider Demographics
NPI:1689844128
Name:LA PORTA, AMALIA (LMSW)
Entity Type:Individual
Prefix:MS
First Name:AMALIA
Middle Name:
Last Name:LA PORTA
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1114 46TH AVE
Mailing Address - Street 2:APT. 3I
Mailing Address - City:LONG ISLAND CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11101-5234
Mailing Address - Country:US
Mailing Address - Phone:917-716-4850
Mailing Address - Fax:
Practice Address - Street 1:681 CLARKSON AVE
Practice Address - Street 2:KINGSBORO PSYCHIATRIC CENTER
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11203-2125
Practice Address - Country:US
Practice Address - Phone:718-388-3075
Practice Address - Fax:718-388-4468
Is Sole Proprietor?:No
Enumeration Date:2008-03-11
Last Update Date:2010-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY071526-1104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY071526-1OtherLMSW