Provider Demographics
NPI:1881622926
Name:AVARALI, MARIANNA (LCSW)
Entity type:Individual
Prefix:
First Name:MARIANNA
Middle Name:
Last Name:AVARALI
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 1:176 N MIDDLETOWN RD
Mailing Address - Street 2:
Mailing Address - City:NANUET
Mailing Address - State:NY
Mailing Address - Zip Code:10954-1316
Mailing Address - Country:US
Mailing Address - Phone:845-215-5726
Mailing Address - Fax:
Practice Address - Street 1:50 SANATORIUM RD
Practice Address - Street 2:BUILDING F
Practice Address - City:POMONA
Practice Address - State:NY
Practice Address - Zip Code:10970-3555
Practice Address - Country:US
Practice Address - Phone:845-364-2416
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0710101041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical