Provider Demographics
NPI:1790110054
Name:SALERNO, KRISTINA (MS, LMHC)
Entity Type:Individual
Prefix:
First Name:KRISTINA
Middle Name:
Last Name:SALERNO
Suffix:
Gender:F
Credentials:MS, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21245 26TH AVE
Mailing Address - Street 2:SUITE 8A
Mailing Address - City:BAYSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11360-1909
Mailing Address - Country:US
Mailing Address - Phone:347-804-4574
Mailing Address - Fax:
Practice Address - Street 1:21245 26TH AVE
Practice Address - Street 2:SUITE 8A
Practice Address - City:BAYSIDE
Practice Address - State:NY
Practice Address - Zip Code:11360-1909
Practice Address - Country:US
Practice Address - Phone:347-804-4574
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-05
Last Update Date:2013-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005092-1101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional