Provider Demographics
NPI:1578054540
Name:SENIOR DIRECT LLC
Entity Type:Organization
Organization Name:SENIOR DIRECT LLC
Other - Org Name:SENIOR DIRECT NY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CAREN
Authorized Official - Middle Name:STACEY
Authorized Official - Last Name:REDLICH
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:914-980-6015
Mailing Address - Street 1:5 GLADWYNE CT
Mailing Address - Street 2:
Mailing Address - City:SPRING VALLEY
Mailing Address - State:NY
Mailing Address - Zip Code:10977-1605
Mailing Address - Country:US
Mailing Address - Phone:914-980-6015
Mailing Address - Fax:845-362-3633
Practice Address - Street 1:5 GLADWYNE CT
Practice Address - Street 2:
Practice Address - City:SPRING VALLEY
Practice Address - State:NY
Practice Address - Zip Code:10977-1605
Practice Address - Country:US
Practice Address - Phone:914-980-6015
Practice Address - Fax:845-362-3633
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-24
Last Update Date:2018-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty