Provider Demographics
NPI:1245719061
Name:LOCANTORE, MARISSA (CASAC-T)
Entity type:Individual
Prefix:
First Name:MARISSA
Middle Name:
Last Name:LOCANTORE
Suffix:
Gender:F
Credentials:CASAC-T
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:412 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12601-3312
Mailing Address - Country:US
Mailing Address - Phone:845-486-8880
Mailing Address - Fax:
Practice Address - Street 1:412 MAIN ST
Practice Address - Street 2:
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12601-3312
Practice Address - Country:US
Practice Address - Phone:845-486-8880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-13
Last Update Date:2025-10-01
Deactivation Date:2023-07-18
Deactivation Code:
Reactivation Date:2025-10-01
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)