Provider Demographics
NPI:1316465552
Name:ANZALONE, NICOLE ROSE (LMHC)
Entity type:Individual
Prefix:MS
First Name:NICOLE
Middle Name:ROSE
Last Name:ANZALONE
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:17 ANZALONE LN
Mailing Address - Street 2:
Mailing Address - City:NEW HAMPTON
Mailing Address - State:NY
Mailing Address - Zip Code:10958-4601
Mailing Address - Country:US
Mailing Address - Phone:845-820-2500
Mailing Address - Fax:
Practice Address - Street 1:1124 STATE ROUTE 94 STE 201
Practice Address - Street 2:
Practice Address - City:NEW WINDSOR
Practice Address - State:NY
Practice Address - Zip Code:12553-7258
Practice Address - Country:US
Practice Address - Phone:845-787-1350
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-08
Last Update Date:2017-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health