Individual
CHRISTIAN MATTHEW DICONSIGLIO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMSW, CASAC-T
Contact information
Practice address
16 SURREY DR, MERRICK, NY 11566-2316
(516) 200-1669
(516) 200-1669
Mailing address
16 SURREY DR, MERRICK, NY 11566-2316
(516) 425-2703
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
127482
NY
Other
Enumeration date
04/15/2026
Last updated
04/15/2026
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