Provider Demographics
NPI:1326634122
Name:LONG ISLAND NEW HOPE COUNSELING SERVICES, LCSW, PLLC
Entity Type:Organization
Organization Name:LONG ISLAND NEW HOPE COUNSELING SERVICES, LCSW, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:R
Authorized Official - Last Name:GIRARD-DOMENA
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:631-974-5052
Mailing Address - Street 1:PO BOX 420
Mailing Address - Street 2:
Mailing Address - City:SOUND BEACH
Mailing Address - State:NY
Mailing Address - Zip Code:11789-0420
Mailing Address - Country:US
Mailing Address - Phone:631-974-5052
Mailing Address - Fax:
Practice Address - Street 1:551 N COUNTRY RD STE 203
Practice Address - Street 2:
Practice Address - City:SAINT JAMES
Practice Address - State:NY
Practice Address - Zip Code:11780-1445
Practice Address - Country:US
Practice Address - Phone:631-974-5052
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-15
Last Update Date:2020-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty