Provider Demographics
NPI:1750740239
Name:MONTEMARANO, HEATHER MARIE (LCAT, LPAT, ATR-BC)
Entity type:Individual
Prefix:MS
First Name:HEATHER
Middle Name:MARIE
Last Name:MONTEMARANO
Suffix:
Gender:F
Credentials:LCAT, LPAT, ATR-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:393 BARTLETT AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10312-2101
Mailing Address - Country:US
Mailing Address - Phone:732-207-6925
Mailing Address - Fax:
Practice Address - Street 1:393 BARTLETT AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10312-2101
Practice Address - Country:US
Practice Address - Phone:732-207-6925
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-12
Last Update Date:2024-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ16LP00023000221700000X
NY002428-01221700000X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Yes221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist