Gina Marie Fattibene, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

0719131 Issued in NY

Practice address

1380 Roanoke Ave
Suite 201
Riverhead, NY 11901-2098

Phone

(631) 369-4418

Fax

(631) 369-4421

NPI assigned

Jan 15, 2007

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Psychological Healthcare, PLLC

  • Professional Counselor
  • Syracuse, NY
  • NPI 1922109578
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1168819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1249516800000",
    "number": "1790836070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "98 WOODLAWN AVE",
            "city": "SAINT JAMES",
            "state": "NY",
            "postal_code": "117802506",
            "telephone_number": "631-369-4418",
            "fax_number": "631-369-4421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1380 ROANOKE AVE",
            "address_2": "SUITE 201",
            "city": "RIVERHEAD",
            "state": "NY",
            "postal_code": "119012098",
            "telephone_number": "631-369-4418",
            "fax_number": "631-369-4421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FATTIBENE",
        "first_name": "GINA",
        "middle_name": "MARIE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-15",
        "last_updated": "2009-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "0719131",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Family Integrated Consulting and Resources, Inc
• Family Servive League
• Laura Fanning, LCSW
• Ahmed Essam Farag, MD
• Zeinab Fathelbab, MD
• Clarissa A Favichia, LMHC
• John J Fazio, CRNA
• Debra Feldman
• Vandy Ferrer, CNM,NP
• Leanne Ferretti, PA

• Clinical Social Worker in Riverhead, NY
• Providers in Riverhead, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.