Provider Demographics
NPI:1477267938
Name:DELIBERATE PSYCHOTHERAPY COLLABORATIVE LCSW
Entity Type:Organization
Organization Name:DELIBERATE PSYCHOTHERAPY COLLABORATIVE LCSW
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOCIAL WORKER
Authorized Official - Prefix:MS
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAH
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-R
Authorized Official - Phone:212-749-3768
Mailing Address - Street 1:336 CENTRAL PARK W APT 11E
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-7124
Mailing Address - Country:US
Mailing Address - Phone:212-749-3768
Mailing Address - Fax:
Practice Address - Street 1:336 CENTRAL PARK W APT 11E
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-7124
Practice Address - Country:US
Practice Address - Phone:212-749-3768
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-10
Last Update Date:2023-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty