Provider Demographics
NPI:1265211056
Name:LETTIERI, COLETTE MARIE (LMSW)
Entity type:Individual
Prefix:
First Name:COLETTE
Middle Name:MARIE
Last Name:LETTIERI
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 WOODLAND AVE
Mailing Address - Street 2:
Mailing Address - City:WESTHAMPTON BEACH
Mailing Address - State:NY
Mailing Address - Zip Code:11978-2347
Mailing Address - Country:US
Mailing Address - Phone:914-562-8590
Mailing Address - Fax:
Practice Address - Street 1:3 WOODLAND AVE
Practice Address - Street 2:
Practice Address - City:WESTHAMPTON BEACH
Practice Address - State:NY
Practice Address - Zip Code:11978-2347
Practice Address - Country:US
Practice Address - Phone:914-562-8590
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-21
Last Update Date:2023-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY077794104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker