Basic Information
| Provider Information | |||||||||
| NPI: | 1023319217 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ALESSIO | ||||||||
| FirstName: | DANIELLE | ||||||||
| MiddleName: | |||||||||
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| Credential: | LCSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 120 MINEOLA BLVD | ||||||||
| Address2: | SUITE 210 | ||||||||
| City: | MINEOLA | ||||||||
| State: | NY | ||||||||
| PostalCode: | 115014064 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5166634600 | ||||||||
| FaxNumber: | 5166632308 | ||||||||
| Practice Location | |||||||||
| Address1: | 120 MINEOLA BLVD | ||||||||
| Address2: | SUITE 210 | ||||||||
| City: | MINEOLA | ||||||||
| State: | NY | ||||||||
| PostalCode: | 115014064 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5166634600 | ||||||||
| FaxNumber: | 5166632308 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/04/2010 | ||||||||
| LastUpdateDate: | 10/16/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | 081925-1 | NY | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical | 1041S0200X | 0803631 | NY | N | Behavioral Health & Social Service Providers | Social Worker | School |
No ID Information.