Sergiacomi, Kenneth Robert

Sergiacomi, Kenneth Robert is an sole proprietor health care provider with primary practice located at 1050 Hallock Ave Suite 4, Port Jefferson Station NY 11776-1214. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Social Worker, Behavioral Health & Social Service Providers / Counselor. Behavioral Health & Social Service Providers / Social Worker is his primary health care specialty. Sergiacomi, Kenneth Robert can be contacted via phone (631) 384-0624.

Contact Information

Primary practice address
1050 Hallock Ave Suite 4 Port Jefferson Station NY 11776-1214
Phone: (631) 384-0624
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Social Worker 104100000X 0735881-1 New York
Behavioral Health & Social Service Providers / Counselor 101Y00000X 0735881-1 New York

Profile Details

NPI number 1336355395
LBN Legal business name Sergiacomi, Kenneth Robert
Credentials L.M.S.W.
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 15th, 2007
Last updated Oct 17th, 2007 - about 17 years ago

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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