Individual
CLARISSA A FAVICHIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMHC
Contact information
Practice address
1380 ROANOKE AVE, 1ST FLOOR, RIVERHEAD, NY 11901-2098
(631) 369-0022
(631) 369-5336
Mailing address
355 WOODLAND AVE, MANORVILLE, NY 11949-2051
(631) 332-2008
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
006740
NY
Other
Enumeration date
08/24/2015
Last updated
09/17/2015
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