Provider Demographics
NPI:1487300539
Name:PASCULLI, DALE E (CRC, LMHC)
Entity type:Individual
Prefix:MRS
First Name:DALE
Middle Name:E
Last Name:PASCULLI
Suffix:
Gender:F
Credentials:CRC, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 SUMMERS ST
Mailing Address - Street 2:
Mailing Address - City:OYSTER BAY
Mailing Address - State:NY
Mailing Address - Zip Code:11771-3710
Mailing Address - Country:US
Mailing Address - Phone:516-922-0420
Mailing Address - Fax:
Practice Address - Street 1:112 SUMMERS ST
Practice Address - Street 2:
Practice Address - City:OYSTER BAY
Practice Address - State:NY
Practice Address - Zip Code:11771-3710
Practice Address - Country:US
Practice Address - Phone:516-922-0420
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-28
Last Update Date:2022-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001730101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health