Provider Demographics
NPI:1275184020
Name:WASHINGTON SQUARE ASSOCIATES, LCSW, PC
Entity Type:Organization
Organization Name:WASHINGTON SQUARE ASSOCIATES, LCSW, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:
Authorized Official - Last Name:HASELEY
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:212-228-1712
Mailing Address - Street 1:136 PROSPECT PARK W APT 6A
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11215-6926
Mailing Address - Country:US
Mailing Address - Phone:212-228-1712
Mailing Address - Fax:
Practice Address - Street 1:31 WASHINGTON SQ W PH B
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-9126
Practice Address - Country:US
Practice Address - Phone:212-228-1712
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-24
Last Update Date:2019-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty