Provider Demographics
NPI:1184218000
Name:THERAPY SERVICE LCSW PLLC
Entity Type:Organization
Organization Name:THERAPY SERVICE LCSW PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:MISS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:SCHULZ
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-R
Authorized Official - Phone:607-297-8720
Mailing Address - Street 1:1121 UPPER FRONT ST
Mailing Address - Street 2:
Mailing Address - City:BINGHAMTON
Mailing Address - State:NY
Mailing Address - Zip Code:13905-1116
Mailing Address - Country:US
Mailing Address - Phone:607-297-8720
Mailing Address - Fax:607-204-0632
Practice Address - Street 1:1121 UPPER FRONT ST
Practice Address - Street 2:
Practice Address - City:BINGHAMTON
Practice Address - State:NY
Practice Address - Zip Code:13905-1116
Practice Address - Country:US
Practice Address - Phone:607-297-8720
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-22
Last Update Date:2021-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty