Provider Demographics
NPI:1407582208
Name:EMOTIONAL HEALTH COUNSELING CONSULTING LCSW PC
Entity Type:Organization
Organization Name:EMOTIONAL HEALTH COUNSELING CONSULTING LCSW PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER & PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:ASHLEY
Authorized Official - Last Name:SULLIVAN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:516-316-5047
Mailing Address - Street 1:105 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SMITHTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:11787-2858
Mailing Address - Country:US
Mailing Address - Phone:516-316-5047
Mailing Address - Fax:631-244-0757
Practice Address - Street 1:105 E MAIN ST
Practice Address - Street 2:
Practice Address - City:SMITHTOWN
Practice Address - State:NY
Practice Address - Zip Code:11787-2858
Practice Address - Country:US
Practice Address - Phone:516-316-5047
Practice Address - Fax:631-244-0757
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-26
Last Update Date:2022-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty