Provider Demographics
NPI:1497591150
Name:ANTONECCHIA, ROSEMARIE (LMHC)
Entity type:Individual
Prefix:
First Name:ROSEMARIE
Middle Name:
Last Name:ANTONECCHIA
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 WESTVIEW TERRACE POUGHKEEPS
Mailing Address - Street 2:26 WESTVIEW TERRACE
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12603
Mailing Address - Country:US
Mailing Address - Phone:914-806-3991
Mailing Address - Fax:
Practice Address - Street 1:26 WESTVIEW TERRACE POUGHKEEPSIE, NY 12603
Practice Address - Street 2:
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12603
Practice Address - Country:US
Practice Address - Phone:914-806-3991
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-02
Last Update Date:2024-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012157101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health