Provider Demographics
NPI:1316970767
Name:HARLIN-LIGNORI, PRISCILLA ANN (LCSW)
Entity type:Individual
Prefix:
First Name:PRISCILLA
Middle Name:ANN
Last Name:HARLIN-LIGNORI
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:PRISCILLA
Other - Middle Name:H
Other - Last Name:LIGNORI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:94 WALLKILL AVE
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:NY
Mailing Address - Zip Code:12549-1512
Mailing Address - Country:US
Mailing Address - Phone:845-457-7726
Mailing Address - Fax:845-457-4265
Practice Address - Street 1:1407 KINGS HIGHWAY
Practice Address - Street 2:
Practice Address - City:SUGAR LOAF
Practice Address - State:NY
Practice Address - Zip Code:10981-0338
Practice Address - Country:US
Practice Address - Phone:845-457-7726
Practice Address - Fax:845-457-4265
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR049623-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYN5K081Medicare ID - Type Unspecified