Provider Demographics
NPI:1154519924
Name:SERRATO, DENISE JOVITA (LCSW, CASAC-T)
Entity type:Individual
Prefix:
First Name:DENISE
Middle Name:JOVITA
Last Name:SERRATO
Suffix:
Gender:F
Credentials:LCSW, CASAC-T
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4580 BROADWAY APT 3L
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10040-2119
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4580 BROADWAY APT 3L
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10040
Practice Address - Country:US
Practice Address - Phone:162-682-5349
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-05
Last Update Date:2018-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0879121104100000X
225400000X
NY0851671041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
No225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00695941Medicaid
NY331957Medicare Oscar/Certification
NY571000Medicare Oscar/Certification
NY331943Medicare Oscar/Certification
NYW6L111Medicare Oscar/Certification
NY331946Medicare Oscar/Certification
NY571056Medicare Oscar/Certification
NYG100000410Medicare Oscar/Certification
NY331952Medicare Oscar/Certification
NY331009Medicare Oscar/Certification
NY331954Medicare Oscar/Certification
NY331043Medicare Oscar/Certification
NY331058Medicare Oscar/Certification
NY331944Medicare Oscar/Certification
NY331947Medicare Oscar/Certification
NY331945Medicare Oscar/Certification
NY331978Medicare Oscar/Certification