Provider Demographics
NPI:1821771957
Name:HOTI, KRISTINA GARRITANO (LMSW)
Entity Type:Individual
Prefix:
First Name:KRISTINA
Middle Name:GARRITANO
Last Name:HOTI
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:480 ROUTE 17M
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10940-4525
Mailing Address - Country:US
Mailing Address - Phone:845-239-4541
Mailing Address - Fax:845-381-1313
Practice Address - Street 1:480 ROUTE 17M
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:NY
Practice Address - Zip Code:10940-4525
Practice Address - Country:US
Practice Address - Phone:845-239-4541
Practice Address - Fax:845-381-1313
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-07
Last Update Date:2023-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP123387104100000X
NY121687-01104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY121687-01OtherNYSED DEPT. OF THE PROFESSIONS REGISTRATION CERTIFICATE