CLARISSA A FAVICHIA (NPI# 1053788190) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053788190 |
| Entity Type | Individual |
| Full Name | CLARISSA A FAVICHIA |
| Credential | LMHC |
| Practice Address |
1380 Roanoke Ave 1st Floor Riverhead NY 11901-2098 |
| Mailing Address |
355 Woodland Ave Manorville NY 11949-2051 |
| Practice Telephone | 6313690022 |
| Practice Fax Number | 6313695336 |
| Mailing Telephone | 6313322008 |
| Enumeration Date | 2015-08-24 |
| Last Update Date | 2015-09-17 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
006740 | NY | Behavioral Health & Social Service Providers |
| Street Address |
1380 ROANOKE AVE 1ST FLOOR |
| City | RIVERHEAD |
| State | NY |
| Zip Code | 11901-2098 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972695377 | Robert W Southard | Nurse Practitioner | 1380 Roanoke Ave, Riverhead, NY 11901-2098 | 2006-09-29 |
| 1841810066 | Johanna St Jean | Social Worker | 1380 Roanoke Ave, Riverhead, NY 11901-2098 | 2020-04-17 |
| 1972019339 | Julie Anne Wisher | Social Worker | 1380 Roanoke Ave, Riverhead, NY 11901-2098 | 2017-12-21 |
| 1538524095 | Kristin Louise Creamer-williamson | Social Worker | 1380 Roanoke Ave, 2nd Floor, Riverhead, NY 11901-2098 | 2015-12-28 |
| 1932577301 | Ramin Azarm | Social Worker | 1380 Roanoke Ave, Riverhead, NY 11901-2098 | 2015-09-02 |
| 1639578461 | Alanna Louise Kugler | Social Worker | 1380 Roanoke Ave, Riverhead, NY 11901-2098 | 2014-08-18 |
| 1720497522 | Genna Sternberg | Social Worker | 1380 Roanoke Ave, Riverhead, NY 11901-2098 | 2014-08-05 |
| 1447662283 | Catherine Rachel Dawson | Social Worker | 1380 Roanoke Ave, Riverhead, NY 11901-2098 | 2014-05-28 |
| 1609204239 | Lauren Alison Hertwig | Nurse Practitioner | 1380 Roanoke Ave, Riverhead, NY 11901-2098 | 2013-10-16 |
| 1568724201 | Nicole L. Bolina | Social Worker | 1380 Roanoke Ave, Riverhead, NY 11901-2098 | 2012-06-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578102786 | Michael Arthur Frangeskos | Physician Assistant | 1330 Roanoke Avenue, Riverhead, NY 11901 | 2020-01-06 |
| 1922569136 | Mjd Optical Corp | Optometrist | 1053 Route 58 Roanoke Ave, Riverhead, NY 11901 | 2019-03-29 |
| 1356837702 | Justin M Liu | Physician Assistant | 31 Main Rd Ste 3, Riverhead, NY 11901 | 2018-07-09 |
| 1467943522 | North Shore Hematology Oncology Associates PC | Clinic/Center | 750 Old Country Rd Bldg 2, Riverhead, NY 11901 | 2018-05-24 |
| 1063918688 | Riverhead Volunteer Ambulance Corps Inc | Ambulance | 111 Osborn Ave, Riverhead, NY 11901 | 2018-04-03 |
| 1669977906 | Joseph Cataldo | Student in an Organized Health Care Education/Training Program | 64 Ida Lane, Riverhead, NY 11901 | 2018-03-28 |
| 1861903056 | The Flanders Northampton Volunteer Ambulance Company Inc | Ambulance | 641 Flanders Road, Flanders, NY 11901 | 2017-10-16 |
| 1336676659 | Patricia Ann Leask | Registered Nurse | 300 Center Drive Suite 250, Methadone Clinic Department of Mental Health, Riverhead, NY 11901 | 2017-05-17 |
| 1922463447 | Diana Williams-burke | Counselor | 550 East Main St Suite 103, Riverhead, NY 11901 | 2015-12-29 |
| 1699155549 | Twin Forks Optometry, Pllc | Optometrist | 25 Cranberry Street, Riverhead, NY 11901 | 2015-06-05 |
| Find all providers in zip 11901 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922463447 | Diana Williams-burke | Counselor | 550 East Main St Suite 103, Riverhead, NY 11901 | 2015-12-29 |
| 1437222007 | Ronald Ira Cohen | Counselor | 240 West Main Street, Riverhead, NY 11901 | 2006-11-15 |
| 1902413909 | Danielle Dahl | Counselor | 208 Roanoke Ave, Riverhead, NY 11901-2706 | 2020-09-24 |
| 1992353270 | Open Door Mental Health Counseling P.C. | Counselor | 940 Roanoke Ave, Riverhead, NY 11901-2749 | 2019-08-29 |
| 1598319998 | August Thilberg | Counselor | 400 W Main St, Riverhead, NY 11901-2813 | 2019-07-25 |
| 1588134910 | Ellen Recker | Counselor | 212 W Main St, Riverhead, NY 11901-2841 | 2018-11-28 |
| 1780166728 | Jennifer Marie Bruno | Counselor | 212 W Main St, Riverhead, NY 11901-2841 | 2018-09-06 |
| 1285137133 | Lea Sirizzotti | Counselor | 212 W Main St, Riverhead, NY 11901 | 2018-03-16 |
| 1013418409 | Brianne O'malley | Counselor | 208 Roanoke Ave, Riverhead, NY 11901-2706 | 2018-02-22 |
| 1184140048 | Jacqueline Hoell Jablonski | Counselor | 810 E Main St, Riverhead, NY 11901-2563 | 2017-08-22 |
| Find all providers in RIVERHEAD | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.