Provider Demographics
NPI:1235022252
Name:LORETONI, KRISTEN TAYLOR (LCSW)
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:TAYLOR
Last Name:LORETONI
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:77 WAYACROSS RD
Mailing Address - Street 2:
Mailing Address - City:MAHOPAC
Mailing Address - State:NY
Mailing Address - Zip Code:10541-1252
Mailing Address - Country:US
Mailing Address - Phone:845-709-7558
Mailing Address - Fax:
Practice Address - Street 1:275 ROUTE 304
Practice Address - Street 2:
Practice Address - City:BARDONIA
Practice Address - State:NY
Practice Address - Zip Code:10954-2049
Practice Address - Country:US
Practice Address - Phone:845-709-7558
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-29
Last Update Date:2025-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1002661041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty