Provider Demographics
NPI:1790221729
Name:SPADAFINO, LUISA (LMFT)
Entity Type:Individual
Prefix:
First Name:LUISA
Middle Name:
Last Name:SPADAFINO
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:522 COURTLANDT AVE
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10451-5008
Mailing Address - Country:US
Mailing Address - Phone:718-312-6486
Mailing Address - Fax:
Practice Address - Street 1:522 COURTLANDT AVE
Practice Address - Street 2:2ND FLOOR
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10451-5008
Practice Address - Country:US
Practice Address - Phone:718-312-6486
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-14
Last Update Date:2017-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY06001362106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist