Provider Demographics
NPI:1003411216
Name:ONLINE THERAPY NYC, LCSW PLLC
Entity Type:Organization
Organization Name:ONLINE THERAPY NYC, LCSW PLLC
Other - Org Name:THE KEELY GROUP LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ERIN
Authorized Official - Middle Name:MCMAUGH
Authorized Official - Last Name:TIERNO
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-R
Authorized Official - Phone:212-317-7055
Mailing Address - Street 1:200 W BUTLER AVE UNIT 3161
Mailing Address - Street 2:
Mailing Address - City:AMBLER
Mailing Address - State:PA
Mailing Address - Zip Code:19002-5854
Mailing Address - Country:US
Mailing Address - Phone:212-317-7055
Mailing Address - Fax:
Practice Address - Street 1:5 UNION SQ W # 1330
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-3306
Practice Address - Country:US
Practice Address - Phone:212-317-7055
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-03
Last Update Date:2022-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty