Doctor Name: | JAMES MAMMONE |
NPI Number: | 1215301213 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LMSW |
License Number: | 082695 |
Business Practice Address: | 93 Main St West Sayville, NY - 117961832 |
Business Phone Number: | 6314741533 |
Business Fax Number: | 6314741533 |
Mailing Address: | 150 Southern Blvd, HAUPPAUGE |
State: | NY |
Postal Code: | 117883524 |
Phone Number: | 6319026617 |
Fax Number: | 6316568888 |
NPI Enumeration Date: | 11/15/2015 |
NPI Last Update Date: | 11/15/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 082695 |
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 |