Provider Demographics
NPI:1912204249
Name:SORVINO, ROBERTA ARIA (MSW)
Entity Type:Individual
Prefix:MS
First Name:ROBERTA
Middle Name:ARIA
Last Name:SORVINO
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:ONE CHRISTOPHER STREET
Mailing Address - Street 2:SUITE1B
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10014-3517
Mailing Address - Country:US
Mailing Address - Phone:212-242-3321
Mailing Address - Fax:201-451-0814
Practice Address - Street 1:1 CHRISTOPHER ST
Practice Address - Street 2:SUITE1B
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10014-3517
Practice Address - Country:US
Practice Address - Phone:212-242-3321
Practice Address - Fax:201-451-0814
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-23
Last Update Date:2011-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR027165-11041C0700X
NJ44SC004334001041C0700X
NJ37F100100300106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist