Provider Demographics
NPI:1386770139
Name:MCGEE-CHIUSANO, LAURA A (LCSW-R, CASAC)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:A
Last Name:MCGEE-CHIUSANO
Suffix:
Gender:F
Credentials:LCSW-R, CASAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:228 NORTHSIDE ROAD
Mailing Address - Street 2:
Mailing Address - City:YAPHANK
Mailing Address - State:NY
Mailing Address - Zip Code:11980
Mailing Address - Country:US
Mailing Address - Phone:631-205-5647
Mailing Address - Fax:
Practice Address - Street 1:4 GERMAN BLVD
Practice Address - Street 2:
Practice Address - City:YAPHANK
Practice Address - State:NY
Practice Address - Zip Code:11980-9627
Practice Address - Country:US
Practice Address - Phone:516-808-4658
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0749951041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical