Provider Demographics
NPI:1225433816
Name:VOLENGY
Entity Type:Organization
Organization Name:VOLENGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRINCIPAL
Authorized Official - Prefix:
Authorized Official - First Name:EON
Authorized Official - Middle Name:
Authorized Official - Last Name:WASHINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-513-5306
Mailing Address - Street 1:442 E 115TH ST
Mailing Address - Street 2:#5B
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029-1708
Mailing Address - Country:US
Mailing Address - Phone:843-513-5306
Mailing Address - Fax:
Practice Address - Street 1:442 E 115TH ST
Practice Address - Street 2:#5B
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-1708
Practice Address - Country:US
Practice Address - Phone:843-513-5306
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-26
Last Update Date:2014-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103K00000X
SC006565251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty