Provider Demographics
NPI:1114558384
Name:GUY C PASCULLI LCSW PC
Entity Type:Organization
Organization Name:GUY C PASCULLI LCSW PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:GUY
Authorized Official - Middle Name:C
Authorized Official - Last Name:PASCULLI
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:212-929-5729
Mailing Address - Street 1:200 W 18TH ST APT 5H
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-4521
Mailing Address - Country:US
Mailing Address - Phone:212-929-5729
Mailing Address - Fax:315-750-3224
Practice Address - Street 1:260 MADISON AVE STE 8089
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-2400
Practice Address - Country:US
Practice Address - Phone:212-929-5729
Practice Address - Fax:315-750-3224
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-28
Last Update Date:2020-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1041C0700XMedicaid