Provider Demographics
NPI:1891343356
Name:CILIOTTA, JEANNINE M (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:JEANNINE
Middle Name:M
Last Name:CILIOTTA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:JEANNINE M
Other - Middle Name:M
Other - Last Name:TOMASELLI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:6516 MORGAN HILL TRL APT 1811
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33411-4813
Mailing Address - Country:US
Mailing Address - Phone:718-757-7602
Mailing Address - Fax:
Practice Address - Street 1:BROOKLYN COUNSELING SERVICES
Practice Address - Street 2:7316 13TH AVE 3RD FLOOR
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11228
Practice Address - Country:US
Practice Address - Phone:718-232-8600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-28
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY10696301104100000X
FL21956104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker