Provider Demographics
NPI:1699363945
Name:AIEVOLI, CLAUDINE A (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:CLAUDINE
Middle Name:A
Last Name:AIEVOLI
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1508 STEVENS AVE
Mailing Address - Street 2:
Mailing Address - City:MERRICK
Mailing Address - State:NY
Mailing Address - Zip Code:11566-2237
Mailing Address - Country:US
Mailing Address - Phone:516-770-0525
Mailing Address - Fax:
Practice Address - Street 1:1508 STEVENS AVE
Practice Address - Street 2:
Practice Address - City:MERRICK
Practice Address - State:NY
Practice Address - Zip Code:11566-2237
Practice Address - Country:US
Practice Address - Phone:516-770-0525
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-04
Last Update Date:2021-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0854141041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical