Provider Demographics
NPI:1427264464
Name:FERRERO-MANGINELLI, ROSEMARY (LCSW)
Entity type:Individual
Prefix:MRS
First Name:ROSEMARY
Middle Name:
Last Name:FERRERO-MANGINELLI
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 1:7530 W SHORE RD
Mailing Address - Street 2:
Mailing Address - City:PORT WASHINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11050-3007
Mailing Address - Country:US
Mailing Address - Phone:516-457-7293
Mailing Address - Fax:516-944-9808
Practice Address - Street 1:101 HILLSIDE AVE
Practice Address - Street 2:SUITE D
Practice Address - City:WILLISTON PARK
Practice Address - State:NY
Practice Address - Zip Code:11596-2347
Practice Address - Country:US
Practice Address - Phone:516-457-7293
Practice Address - Fax:516-944-9808
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-15
Last Update Date:2007-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X
NY075795-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)