Provider Demographics
NPI:1053081042
Name:THE COMMUNITY COUCH LCSW PLLC
Entity Type:Organization
Organization Name:THE COMMUNITY COUCH LCSW PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ORIGINAL MEMBER
Authorized Official - Prefix:MS
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:FLANAGAN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:347-244-5989
Mailing Address - Street 1:6801 SHORE RD APT 2C
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11220-5026
Mailing Address - Country:US
Mailing Address - Phone:347-517-5369
Mailing Address - Fax:
Practice Address - Street 1:116 WEST 23RD STREET
Practice Address - Street 2:SUITE 500 - ROOM 33
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011
Practice Address - Country:US
Practice Address - Phone:347-244-5989
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-20
Last Update Date:2021-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty