Provider Demographics
NPI:1043033715
Name:ZACCHIA, ALINA (LSMW)
Entity type:Individual
Prefix:
First Name:ALINA
Middle Name:
Last Name:ZACCHIA
Suffix:
Gender:F
Credentials:LSMW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 JASON PL
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10940-1909
Mailing Address - Country:US
Mailing Address - Phone:845-800-5118
Mailing Address - Fax:
Practice Address - Street 1:14 JASON PL
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:NY
Practice Address - Zip Code:10940-1909
Practice Address - Country:US
Practice Address - Phone:845-800-5118
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-01
Last Update Date:2024-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY124342104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker