Provider Demographics
NPI:1902010796
Name:PARENTE, LOUISE (PHD LCSW)
Entity Type:Individual
Prefix:MRS
First Name:LOUISE
Middle Name:
Last Name:PARENTE
Suffix:
Gender:F
Credentials:PHD LCSW
Other - Prefix:MISS
Other - First Name:LOUISE
Other - Middle Name:
Other - Last Name:RUSSO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:103 AUGUSTA AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10312-3434
Mailing Address - Country:US
Mailing Address - Phone:718-356-9015
Mailing Address - Fax:718-356-9015
Practice Address - Street 1:312 BEMENT AVENUE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10310
Practice Address - Country:US
Practice Address - Phone:718-442-1180
Practice Address - Fax:715-356-9015
Is Sole Proprietor?:No
Enumeration Date:2007-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC014333001041C0700X
NYRP0352431041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical