Provider Demographics
NPI:1750028643
Name:BRANCATO, JOHN ANTHONY (MHC-LP)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:ANTHONY
Last Name:BRANCATO
Suffix:
Gender:M
Credentials:MHC-LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2341 BOYNTON PL
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11223-4632
Mailing Address - Country:US
Mailing Address - Phone:917-836-9976
Mailing Address - Fax:
Practice Address - Street 1:10232 65TH AVE APT B44
Practice Address - Street 2:
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-1707
Practice Address - Country:US
Practice Address - Phone:347-463-8066
Practice Address - Fax:646-844-5961
Is Sole Proprietor?:No
Enumeration Date:2022-05-12
Last Update Date:2022-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY111275-01101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health