Individual ProviderKrystie Marie IzzoCounselorBehavioral Health & Social Service ProvidersPractice Address2460 Victory Blvd, Staten Island, NY 10314(718) 477-0228(646) 220-4406PECOS EnrollmentBased on the most recent information from CMS, provider Krystie Marie Izzo does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 1:08 PM.Profile DetailsProvider ID1407273352Provider TypeIndividualFull NameIzzo, Krystie MarieTitleMrs.CredentialLMHCGenderFemaleSole ProprietorYesEnumeration Date3/27/2014Last Updated9/3/2018Contact InformationPractice LocationPractice Address2460 Victory Blvd, Staten Island, NY 10314Phone(718) 477-0228FaxUnlisted FaxMailing LocationMailing Address2460 Victory Blvd, Staten Island, NY 10314-6612Phone(646) 220-4406FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode101YM0800XPrimaryDescriptionCounselorBehavioral Health & Social Service ProvidersLicense007045New YorkCode101YM0800XDescriptionCounselorBehavioral Health & Social Service ProvidersLicense007045-1New York