Provider Demographics
NPI:1255452520
Name:INGENITO, DENISE (LCSW)
Entity type:Individual
Prefix:
First Name:DENISE
Middle Name:
Last Name:INGENITO
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 1:144 S 6TH ST
Mailing Address - Street 2:
Mailing Address - City:BETHPAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11714-2510
Mailing Address - Country:US
Mailing Address - Phone:516-749-5989
Mailing Address - Fax:
Practice Address - Street 1:1918 BELLMORE AVE
Practice Address - Street 2:SUITE B
Practice Address - City:NORTH BELLMORE
Practice Address - State:NY
Practice Address - Zip Code:11710-5641
Practice Address - Country:US
Practice Address - Phone:516-749-5989
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-03
Last Update Date:2007-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP063028-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical