Provider Demographics
NPI:1710466016
Name:STAVOLA, FRANCIS MICHAEL (LMHC)
Entity Type:Individual
Prefix:
First Name:FRANCIS
Middle Name:MICHAEL
Last Name:STAVOLA
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 DELMAR AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10312-2840
Mailing Address - Country:US
Mailing Address - Phone:917-842-1408
Mailing Address - Fax:
Practice Address - Street 1:201 FOREST AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10301-2763
Practice Address - Country:US
Practice Address - Phone:718-815-3155
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-08
Last Update Date:2018-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008762101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health