Provider Demographics
NPI:1053968396
Name:ANTONETTY, ASHLEY BRIGITTE (MHC)
Entity type:Individual
Prefix:MS
First Name:ASHLEY
Middle Name:BRIGITTE
Last Name:ANTONETTY
Suffix:
Gender:F
Credentials:MHC
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:BRIGITTE
Other - Last Name:LOBATO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:348 13TH ST STE 203
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11215-6179
Mailing Address - Country:US
Mailing Address - Phone:718-536-7985
Mailing Address - Fax:
Practice Address - Street 1:348 13TH ST STE 203
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11215-6179
Practice Address - Country:US
Practice Address - Phone:718-536-7985
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-21
Last Update Date:2019-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health