Provider Demographics
NPI:1023380771
Name:NEW HORIZONS LCSW, PC
Entity Type:Organization
Organization Name:NEW HORIZONS LCSW, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ANA
Authorized Official - Middle Name:
Authorized Official - Last Name:CARRION
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LCSW-R
Authorized Official - Phone:631-766-8989
Mailing Address - Street 1:14 WASHINGTON AVE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:BRENTWOOD
Mailing Address - State:NY
Mailing Address - Zip Code:11717-3247
Mailing Address - Country:US
Mailing Address - Phone:631-766-8989
Mailing Address - Fax:888-272-0686
Practice Address - Street 1:14 WASHINGTON AVE
Practice Address - Street 2:SUITE 2
Practice Address - City:BRENTWOOD
Practice Address - State:NY
Practice Address - Zip Code:11717-3247
Practice Address - Country:US
Practice Address - Phone:631-766-8989
Practice Address - Fax:888-272-0686
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-26
Last Update Date:2015-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR-051132-11041C0700X
NY1084828801041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchoolGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03345677Medicaid
NY03345677Medicaid