| Doctor Name: | MRS. LUANN MONGIELLO ESEN |
| NPI Number: | 1114053543 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LCSW BCD |
| License Number: | R0528361 |
| Business Practice Address: | 3771 Nesconset Hwy Suite 208a Centereach, NY - 11720 |
| Business Phone Number: | 6314283019 |
| Business Fax Number: | 6319290182 |
| Mailing Address: | 245 Hidden Pond Path, WADING RIVER |
| State: | NY |
| Postal Code: | 11792 |
| Phone Number: | 6314283019 |
| Fax Number: | 6319290182 |
| NPI Enumeration Date: | 02/27/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | R0528361 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |