Provider Demographics
NPI:1821398090
Name:LIONAKIS, CAROL ANN (EARLY INTERVENTION T)
Entity Type:Individual
Prefix:MRS
First Name:CAROL
Middle Name:ANN
Last Name:LIONAKIS
Suffix:
Gender:F
Credentials:EARLY INTERVENTION T
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35-69 164TH STREET
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11358-1718
Mailing Address - Country:US
Mailing Address - Phone:917-407-8484
Mailing Address - Fax:
Practice Address - Street 1:35-69 164TH STREET
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11358-1718
Practice Address - Country:US
Practice Address - Phone:917-407-8484
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-22
Last Update Date:2010-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY22200101YM0800X
NY173873071101YM0800X
NY409837102101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health