Provider Demographics
NPI:1134762545
Name:LEONE, DANIELLE DONNA
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:DONNA
Last Name:LEONE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 HENRY ST
Mailing Address - Street 2:
Mailing Address - City:KINGS PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11754-2714
Mailing Address - Country:US
Mailing Address - Phone:631-663-5757
Mailing Address - Fax:631-663-5758
Practice Address - Street 1:46 PULASKI RD
Practice Address - Street 2:
Practice Address - City:KINGS PARK
Practice Address - State:NY
Practice Address - Zip Code:11754-2531
Practice Address - Country:US
Practice Address - Phone:631-663-5757
Practice Address - Fax:631-663-5758
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-18
Last Update Date:2019-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)