Provider Demographics
NPI:1316032782
Name:YOUTH AND FAMILY COUNSELING AGENCY OF OYSTER BAY-EAST NORWICH, INC
Entity Type:Organization
Organization Name:YOUTH AND FAMILY COUNSELING AGENCY OF OYSTER BAY-EAST NORWICH, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:
Authorized Official - Last Name:RAKUSIN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:516-922-6867
Mailing Address - Street 1:193A SOUTH STREET
Mailing Address - Street 2:
Mailing Address - City:OYSTER BAY
Mailing Address - State:NY
Mailing Address - Zip Code:11771
Mailing Address - Country:US
Mailing Address - Phone:516-922-6867
Mailing Address - Fax:
Practice Address - Street 1:193A SOUTH STREET
Practice Address - Street 2:
Practice Address - City:OYSTER BAY
Practice Address - State:NY
Practice Address - Zip Code:11771
Practice Address - Country:US
Practice Address - Phone:516-922-6867
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2008-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY00358251V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable