Provider Demographics
NPI:1235709155
Name:PIETA, KINGA
Entity type:Individual
Prefix:
First Name:KINGA
Middle Name:
Last Name:PIETA
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:83 WESTERN HWY
Mailing Address - Street 2:
Mailing Address - City:WEST NYACK
Mailing Address - State:NY
Mailing Address - Zip Code:10994-2619
Mailing Address - Country:US
Mailing Address - Phone:718-755-5770
Mailing Address - Fax:
Practice Address - Street 1:83 WESTERN HWY
Practice Address - Street 2:
Practice Address - City:WEST NYACK
Practice Address - State:NY
Practice Address - Zip Code:10994-2619
Practice Address - Country:US
Practice Address - Phone:718-755-5770
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-01
Last Update Date:2025-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW240911041C0700X
NY0986951041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY114770OtherLMSW
VA0903004140OtherLMSW