Provider Demographics
NPI:1588128052
Name:CALABRESE, ANTHONY (LCSW)
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:
Last Name:CALABRESE
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:46 CAMPBELL ST
Mailing Address - Street 2:
Mailing Address - City:PATCHOGUE
Mailing Address - State:NY
Mailing Address - Zip Code:11772-3607
Mailing Address - Country:US
Mailing Address - Phone:631-250-5713
Mailing Address - Fax:
Practice Address - Street 1:600 JOHNSON AVE STE C13
Practice Address - Street 2:
Practice Address - City:BOHEMIA
Practice Address - State:NY
Practice Address - Zip Code:11716-2674
Practice Address - Country:US
Practice Address - Phone:631-250-5713
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-29
Last Update Date:2022-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1009031041C0700X
NY0919781041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical