Provider Demographics
NPI:1912227315
Name:NUNNO, EILEEN MARY (LMHC)
Entity Type:Individual
Prefix:MS
First Name:EILEEN
Middle Name:MARY
Last Name:NUNNO
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:MRS
Other - First Name:EILEEN
Other - Middle Name:MARY
Other - Last Name:DEJESUS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 69
Mailing Address - Street 2:
Mailing Address - City:WEST PARK
Mailing Address - State:NY
Mailing Address - Zip Code:12493-0069
Mailing Address - Country:US
Mailing Address - Phone:845-384-6500
Mailing Address - Fax:845-384-6001
Practice Address - Street 1:2085 ROUTE 9W
Practice Address - Street 2:
Practice Address - City:WEST PARK
Practice Address - State:NY
Practice Address - Zip Code:12493-0069
Practice Address - Country:US
Practice Address - Phone:845-384-6500
Practice Address - Fax:845-384-6001
Is Sole Proprietor?:No
Enumeration Date:2010-06-08
Last Update Date:2010-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000119101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health