Provider Demographics
NPI:1083967970
Name:LATINO SUPPORT LCSW, P.C
Entity Type:Organization
Organization Name:LATINO SUPPORT LCSW, P.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:T
Authorized Official - Last Name:SCHREIBER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-R
Authorized Official - Phone:718-505-1531
Mailing Address - Street 1:P.O. BOX 630333
Mailing Address - Street 2:
Mailing Address - City:LITTLE NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11363
Mailing Address - Country:US
Mailing Address - Phone:718-505-1531
Mailing Address - Fax:347-808-9871
Practice Address - Street 1:4322 50 STREET
Practice Address - Street 2:SUITE 2C
Practice Address - City:WOODSIDE
Practice Address - State:NY
Practice Address - Zip Code:11377
Practice Address - Country:US
Practice Address - Phone:718-505-1531
Practice Address - Fax:347-808-9871
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-17
Last Update Date:2021-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY079970251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health