Provider Demographics
NPI:1962618256
Name:RANIERI, ROBERT A (LMHC)
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:A
Last Name:RANIERI
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:83 ASTOR AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT JAMES
Mailing Address - State:NY
Mailing Address - Zip Code:11780-3021
Mailing Address - Country:US
Mailing Address - Phone:631-584-6961
Mailing Address - Fax:631-584-3610
Practice Address - Street 1:83 ASTOR AVE
Practice Address - Street 2:
Practice Address - City:SAINT JAMES
Practice Address - State:NY
Practice Address - Zip Code:11780-3021
Practice Address - Country:US
Practice Address - Phone:631-584-6961
Practice Address - Fax:631-584-3610
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000095101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health