Provider Demographics
NPI:1730605106
Name:SCIMECA, JOANN (MS-MHC-LP, CASAC)
Entity type:Individual
Prefix:MS
First Name:JOANN
Middle Name:
Last Name:SCIMECA
Suffix:
Gender:F
Credentials:MS-MHC-LP, CASAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2508 7TH AVE
Mailing Address - Street 2:
Mailing Address - City:EAST MEADOW
Mailing Address - State:NY
Mailing Address - Zip Code:11554-3328
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:37 JOHN ST
Practice Address - Street 2:
Practice Address - City:AMITYVILLE
Practice Address - State:NY
Practice Address - Zip Code:11701-2930
Practice Address - Country:US
Practice Address - Phone:631-424-2900
Practice Address - Fax:631-608-1057
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-17
Last Update Date:2017-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY33211101YA0400X
NY008143101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)