Provider Demographics
NPI:1588231773
Name:LOVE INSPIRES PSYCHOTHERAPY LCSW P.C.
Entity Type:Organization
Organization Name:LOVE INSPIRES PSYCHOTHERAPY LCSW P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NASHON
Authorized Official - Middle Name:
Authorized Official - Last Name:CLARK
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-R
Authorized Official - Phone:516-600-0440
Mailing Address - Street 1:100 BROADHOLLOW RD STE 317
Mailing Address - Street 2:
Mailing Address - City:FARMINGDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11735-4813
Mailing Address - Country:US
Mailing Address - Phone:516-600-0440
Mailing Address - Fax:516-600-0441
Practice Address - Street 1:100 BROADHOLLOW RD STE 317
Practice Address - Street 2:
Practice Address - City:FARMINGDALE
Practice Address - State:NY
Practice Address - Zip Code:11735-4813
Practice Address - Country:US
Practice Address - Phone:516-600-0440
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-07
Last Update Date:2021-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty