Provider Demographics
NPI:1306434964
Name:BATTISTONI, ERICKA (LMSW)
Entity type:Individual
Prefix:
First Name:ERICKA
Middle Name:
Last Name:BATTISTONI
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 HASWELL RD
Mailing Address - Street 2:
Mailing Address - City:WATERVLIET
Mailing Address - State:NY
Mailing Address - Zip Code:12189-1302
Mailing Address - Country:US
Mailing Address - Phone:518-273-4911
Mailing Address - Fax:
Practice Address - Street 1:11 HASWELL RD
Practice Address - Street 2:
Practice Address - City:WATERVLIET
Practice Address - State:NY
Practice Address - Zip Code:12189-1302
Practice Address - Country:US
Practice Address - Phone:518-273-4911
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-08
Last Update Date:2021-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY085511104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker