Provider Demographics
NPI:1881864478
Name:IACURTO, LINDA (MA, ATR-BC, LCAT)
Entity Type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:
Last Name:IACURTO
Suffix:
Gender:F
Credentials:MA, ATR-BC, LCAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:174 TALLMAN ST
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10312-4816
Mailing Address - Country:US
Mailing Address - Phone:718-984-5444
Mailing Address - Fax:718-317-9538
Practice Address - Street 1:174 TALLMAN ST
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10312-4816
Practice Address - Country:US
Practice Address - Phone:718-984-5444
Practice Address - Fax:718-317-9538
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-10
Last Update Date:2021-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000677-1101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty