Provider Demographics
NPI:1588817746
Name:FAMILY FOCUS LCSW-R, PC
Entity Type:Organization
Organization Name:FAMILY FOCUS LCSW-R, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:BRUNDAGE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-R
Authorized Official - Phone:845-227-1962
Mailing Address - Street 1:8 WRIGHT BLVD
Mailing Address - Street 2:
Mailing Address - City:HOPEWELL JUNCTION
Mailing Address - State:NY
Mailing Address - Zip Code:12533-5146
Mailing Address - Country:US
Mailing Address - Phone:845-227-1962
Mailing Address - Fax:854-223-3829
Practice Address - Street 1:2799 W MAIN ST
Practice Address - Street 2:SUITE C
Practice Address - City:WAPPINGERS FALLS
Practice Address - State:NY
Practice Address - Zip Code:12590-1577
Practice Address - Country:US
Practice Address - Phone:845-227-1962
Practice Address - Fax:845-223-3829
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-31
Last Update Date:2008-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYRO42597-1252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency