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

Individual provider Clinical Social Worker · NPI 1083134605

Tara Jean Petrungaro, LCSW is a Clinical Social Worker in Lake Ronkonkoma, New York. Practices as a sole proprietor. Licensed in New York.

Licensed in
NY
In the registry since
2017
What do these letters mean?
LCSW — Licensed Clinical Social Worker
A social worker licensed to diagnose and treat mental health conditions independently.

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Practice location Address checks out

181 Lorenzo Cir
Lake Ronkonkoma, NY 11779-2279
Phone: (631) 708-9309
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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 075742-1 (NY)

Record details

NPI number1083134605
Entity typeIndividual (Type 1)
GenderFemale
Credentials LCSW
Sole proprietorYes
NPI enumeratedJune 24, 2017
Last updated in NPPESSeptember 6, 2022
Certification dateSeptember 6, 2022

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