Provider Demographics
NPI:1245738343
Name:UNITED COUNSELING ASSOCIATES LCSW LLC
Entity Type:Organization
Organization Name:UNITED COUNSELING ASSOCIATES LCSW LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DUJARDIN
Authorized Official - Middle Name:
Authorized Official - Last Name:BONET
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-R, MSW
Authorized Official - Phone:917-817-4422
Mailing Address - Street 1:107 FLEET CT
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10473-2454
Mailing Address - Country:US
Mailing Address - Phone:917-817-4422
Mailing Address - Fax:
Practice Address - Street 1:107 FLEET CT
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10473-2454
Practice Address - Country:US
Practice Address - Phone:917-817-4422
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-24
Last Update Date:2018-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0606131041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty