Provider Demographics
NPI:1871288274
Name:CREATING CONNECTIONS TOGETHER, LCSW, PLLC
Entity type:Organization
Organization Name:CREATING CONNECTIONS TOGETHER, LCSW, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOANN
Authorized Official - Middle Name:
Authorized Official - Last Name:MAZZOCCHI-FLEITZ
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-R
Authorized Official - Phone:914-475-1405
Mailing Address - Street 1:100 GREAT OAKS BLVD STE 117A
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12203-7925
Mailing Address - Country:US
Mailing Address - Phone:914-475-1405
Mailing Address - Fax:
Practice Address - Street 1:100 GREAT OAKS BLVD STE 117A
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12203-7925
Practice Address - Country:US
Practice Address - Phone:914-475-1405
Practice Address - Fax:518-438-0382
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-10
Last Update Date:2024-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty