Provider Demographics
NPI:1316318223
Name:PITINGARO, JAIME (LCSW)
Entity type:Individual
Prefix:
First Name:JAIME
Middle Name:
Last Name:PITINGARO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:164 SUGARLOAF MOUNTAIN RD
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:10918-2500
Mailing Address - Country:US
Mailing Address - Phone:845-721-7970
Mailing Address - Fax:
Practice Address - Street 1:164 SUGARLOAF MOUNTAIN RD
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:NY
Practice Address - Zip Code:10918-2500
Practice Address - Country:US
Practice Address - Phone:845-721-7970
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-19
Last Update Date:2023-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0915431041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY082242OtherLICENSED MASTER SOCIAL WORKER