Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Catherine Provenzano

Organization Clinical Social Worker · NPI 1669875936

Catherine Provenzano is a Clinical Social Worker in Port Jefferson Station, New York. Licensed in New York. Registered with an NPI since 2014.

Licensed in
NY
In the registry since
2014

Practice location Address checks out

1050 Hallock Ave
Port Jefferson Station, NY 11776-1214
Phone: (631) 487-5162
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 081438 (NY)

Record details

NPI number1669875936
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Catherine Provenzano — Clinical Social Worker · (631) 487-5162
NPI enumeratedOctober 1, 2014
Last updated in NPPESOctober 1, 2014
Mailing address1050 Hallock Ave, Port Jefferson Station, NY 11776-1214

Other providers in Port Jefferson Station