Provider Demographics
NPI:1962256065
Name:ALLEGRO PSYCHOTHERAPY
Entity type:Organization
Organization Name:ALLEGRO PSYCHOTHERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR - MENTAL HEALTH
Authorized Official - Prefix:
Authorized Official - First Name:DEANA
Authorized Official - Middle Name:ROSE
Authorized Official - Last Name:BOLOGNA
Authorized Official - Suffix:
Authorized Official - Credentials:OWNER
Authorized Official - Phone:516-243-7909
Mailing Address - Street 1:28 WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:SMITHTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:11787-5525
Mailing Address - Country:US
Mailing Address - Phone:516-243-7909
Mailing Address - Fax:
Practice Address - Street 1:28 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:SMITHTOWN
Practice Address - State:NY
Practice Address - Zip Code:11787-5525
Practice Address - Country:US
Practice Address - Phone:516-243-7909
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-15
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty