| Gabrielle Fasano, Lcsw, Pllc | |
|
46 Route 25a Ste 3 Setauket NY 11733-2806 | |
| (631) 517-3345 | |
| Not Available |
| Full Name | Gabrielle Fasano, Lcsw, Pllc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 46 Route 25a Ste 3, Setauket, New York |
| Authorized Official Name and Position | Gabrielle Fasano (OWNER) |
| Authorized Official Contact | 6314885118 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gabrielle Fasano, Lcsw, Pllc 20 Wyckoff Ave Port Jefferson Station NY 11776-1420 Ph: (631) 488-5118 | Gabrielle Fasano, Lcsw, Pllc 46 Route 25a Ste 3 Setauket NY 11733-2806 Ph: (631) 517-3345 |
| NPI Number | 1922792951 |
|---|---|
| Provider Enumeration Date | 06/05/2023 |
| Last Update Date | 06/05/2023 |
| Certification Date | 06/03/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922792951 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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