Provider Demographics
NPI:1346774395
Name:STRAIGHT TALK PSYCHOTHERAY
Entity Type:Organization
Organization Name:STRAIGHT TALK PSYCHOTHERAY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOCIAL WORKER
Authorized Official - Prefix:MISS
Authorized Official - First Name:ZOE
Authorized Official - Middle Name:
Authorized Official - Last Name:REYES
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:917-972-6640
Mailing Address - Street 1:161 W 54TH ST
Mailing Address - Street 2:SUITE 804
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10019-5322
Mailing Address - Country:US
Mailing Address - Phone:917-972-6640
Mailing Address - Fax:
Practice Address - Street 1:161 W 54TH ST
Practice Address - Street 2:SUITE 804
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-5322
Practice Address - Country:US
Practice Address - Phone:917-972-6640
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-17
Last Update Date:2017-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty