Provider Demographics
NPI:1508617564
Name:NEW YORK VILLAGE PSYCHOTHERAPY LCSW P.C.
Entity Type:Organization
Organization Name:NEW YORK VILLAGE PSYCHOTHERAPY LCSW P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JOSH
Authorized Official - Middle Name:A
Authorized Official - Last Name:JONAS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-R
Authorized Official - Phone:347-681-0764
Mailing Address - Street 1:14 SYDNEY HILL RD
Mailing Address - Street 2:
Mailing Address - City:SARATOGA SPGS
Mailing Address - State:NY
Mailing Address - Zip Code:12866-8598
Mailing Address - Country:US
Mailing Address - Phone:347-681-0764
Mailing Address - Fax:
Practice Address - Street 1:226 E 54TH ST STE 400-B
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-4854
Practice Address - Country:US
Practice Address - Phone:347-681-0764
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-28
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty