Provider Demographics
NPI:1134868961
Name:CALABRESE, RENEE (LMSW, CASAC)
Entity type:Individual
Prefix:MS
First Name:RENEE
Middle Name:
Last Name:CALABRESE
Suffix:
Gender:
Credentials:LMSW, CASAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 JOHNSON AVE STE C13
Mailing Address - Street 2:
Mailing Address - City:BOHEMIA
Mailing Address - State:NY
Mailing Address - Zip Code:11716-2674
Mailing Address - Country:US
Mailing Address - Phone:631-949-2145
Mailing Address - Fax:
Practice Address - Street 1:600 JOHNSON AVE STE C13
Practice Address - Street 2:
Practice Address - City:BOHEMIA
Practice Address - State:NY
Practice Address - Zip Code:11716-2674
Practice Address - Country:US
Practice Address - Phone:631-949-2145
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-31
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY33727101YA0400X
NY107014-01104100000X
NY1070141041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No104100000XBehavioral Health & Social Service ProvidersSocial Worker