Gina Marie Cannistra, LCSW

Individual provider Active NPI Clinical Social Worker · Frankfort, NY

NPI 1659746485 · NPPES record last updated Dec 4, 2015

Key facts

NPI
1659746485
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
0736571 (NY)
Practice address
228 Eldred Ave
Frankfort, NY 13340-5119
Phone
(315) 527-5332
NPI assigned
Dec 4, 2015
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
0736571NYMDClinical Social Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 0736571 NY Yes

Addresses

Primary practice location

228 Eldred Ave
Frankfort, NY 13340-5119

Mailing address

228 Eldred Ave
Frankfort, NY 13340-5119
Phone (315) 527-5332

Other providers in Frankfort, NY

All providers in Frankfort, NY · Clinical Social Worker in New York

Sources for this page

Verify at the official NPI Registry.