Provider Demographics
NPI:1487050753
Name:VIGILANTE, DINA (LCSW-R)
Entity type:Individual
Prefix:MRS
First Name:DINA
Middle Name:
Last Name:VIGILANTE
Suffix:
Gender:F
Credentials:LCSW-R
Other - Prefix:MS
Other - First Name:DINA
Other - Middle Name:
Other - Last Name:CHIRICO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW-R
Mailing Address - Street 1:1 OLD CHESTNUT RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:MONTVALE
Mailing Address - State:NJ
Mailing Address - Zip Code:07645-1046
Mailing Address - Country:US
Mailing Address - Phone:914-552-4578
Mailing Address - Fax:
Practice Address - Street 1:1156 N BROADWAY
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10701-1108
Practice Address - Country:US
Practice Address - Phone:914-965-3701
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-11-13
Last Update Date:2014-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0749791041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical