Mazzone, Amanda Rose

Mazzone, Amanda Rose is an individual health care provider with primary practice located at 58 Richmond Blvd Unit 3B , Ronkonkoma NY 11779-3405. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Social Worker, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Mazzone, Amanda Rose can be contacted via phone (631) 885-2257.

Contact Information

Primary practice address
58 Richmond Blvd Unit 3B Ronkonkoma NY 11779-3405
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Social Worker 104100000X 72094788 New York
Behavioral Health & Social Service Providers / Clinical 1041C0700X 088549 New York

Profile Details

NPI number 1497133979
LBN Legal business name Mazzone, Amanda Rose
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 No
Enumeration date May 15th, 2015
Last updated Dec 12th, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1497133979 NPPES
New York MEDICAID 02173802

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