Provider Demographics
NPI:1518347236
Name:LCSW THERAPY SERVICES OF NY PLLC
Entity Type:Organization
Organization Name:LCSW THERAPY SERVICES OF NY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:LINDSEY
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:845-489-8818
Mailing Address - Street 1:11940 METROPOLITAN AVE
Mailing Address - Street 2:APT C3
Mailing Address - City:KEW GARDENS
Mailing Address - State:NY
Mailing Address - Zip Code:11415-2600
Mailing Address - Country:US
Mailing Address - Phone:845-489-8818
Mailing Address - Fax:
Practice Address - Street 1:10505 69TH AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-3372
Practice Address - Country:US
Practice Address - Phone:845-489-8818
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-08
Last Update Date:2015-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0801421041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty