Provider Demographics
NPI:1730264276
Name:CATTANO, JOSEPH A (LCSW, PHD)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:A
Last Name:CATTANO
Suffix:
Gender:M
Credentials:LCSW, PHD
Other - Prefix:DR
Other - First Name:JOSEPH
Other - Middle Name:A
Other - Last Name:CATTANO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW, CASAC
Mailing Address - Street 1:36 EAST WOODBINE DRIVE
Mailing Address - Street 2:
Mailing Address - City:FREEPORT
Mailing Address - State:NY
Mailing Address - Zip Code:11520-2122
Mailing Address - Country:US
Mailing Address - Phone:516-623-6715
Mailing Address - Fax:516-623-5353
Practice Address - Street 1:36 EAST WOODBINE DRIVE
Practice Address - Street 2:
Practice Address - City:FREEPORT
Practice Address - State:NY
Practice Address - Zip Code:11520-2122
Practice Address - Country:US
Practice Address - Phone:516-623-6715
Practice Address - Fax:516-623-5353
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY020574LCSW1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYN00492Medicare ID - Type Unspecified