Provider Demographics
NPI:1700184140
Name:ACCARDI, CONSTANTINA
Entity Type:Individual
Prefix:
First Name:CONSTANTINA
Middle Name:
Last Name:ACCARDI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:TINA
Other - Middle Name:
Other - Last Name:ACCARDI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA, LMFT
Mailing Address - Street 1:16232 85TH ST
Mailing Address - Street 2:
Mailing Address - City:HOWARD BEACH
Mailing Address - State:NY
Mailing Address - Zip Code:11414-3323
Mailing Address - Country:US
Mailing Address - Phone:917-428-3797
Mailing Address - Fax:718-272-1739
Practice Address - Street 1:1 BARSTOW RD
Practice Address - Street 2:STE. P24
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11021-3540
Practice Address - Country:US
Practice Address - Phone:917-428-3797
Practice Address - Fax:718-272-1739
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-09
Last Update Date:2011-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000856-1106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist