Individual
EMILY FASOLINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CASAC-T
Contact information
Practice address
452 SUFFOLK AVE, BRENTWOOD, NY 11717-4214
(631) 436-6065
Mailing address
363 BAY AVE APT 4, PATCHOGUE, NY 11772-4055
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
40972
NY
Other
Enumeration date
10/15/2025
Last updated
10/15/2025
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