Provider Demographics
NPI:1326250721
Name:SOCCI, PHILIP D JR (LCSW)
Entity Type:Individual
Prefix:MR
First Name:PHILIP
Middle Name:D
Last Name:SOCCI
Suffix:JR
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:230 W 13TH ST FL 2
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-7700
Mailing Address - Country:US
Mailing Address - Phone:646-342-5913
Mailing Address - Fax:
Practice Address - Street 1:230 W 13TH ST STE F
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-7746
Practice Address - Country:US
Practice Address - Phone:646-342-5913
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-06
Last Update Date:2009-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0758121041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical