Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
THERESA ROSE DOMENICHELLO, LCSW
Active Sole ProprietorTHERESA ROSE DOMENICHELLO, LCSW is a Social Worker healthcare provider located in PORT JEFF STA, New York. NPI 1427646074 is currently active in the NPPES registry. Verify at CMS.
Social Worker · PORT JEFF STA, NY
Registration Details
- NPI Number
- 1427646074
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Jan 8, 2021 (5.6002044506106 yrs)
- Last Updated
- Oct 21, 2024
- License
-
106018 (NY)
- Sole Proprietor
- Yes
Practice Information
- Address
-
646 MAIN ST STE 206PORT JEFF STA, NY, 117772230Browse NY providers · Browse ZIP 11777
- Phone
- 6312139377
- Primary Specialty
-
Social Worker
104100000X
Other Social Worker Providers in PORT JEFF STA, NY
| Name | Credential | NPI |
|---|---|---|
| ALISSA BROOKS | LCSW | 1063008209 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.