Provider Demographics
NPI:1598140998
Name:ALL ISLAND COUNSELING LCSW PC
Entity Type:Organization
Organization Name:ALL ISLAND COUNSELING LCSW PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOAN
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:RYAN
Authorized Official - Suffix:I
Authorized Official - Credentials:LCSW-R
Authorized Official - Phone:631-252-5740
Mailing Address - Street 1:127 GATELOT AVE
Mailing Address - Street 2:
Mailing Address - City:RONKONKOMA
Mailing Address - State:NY
Mailing Address - Zip Code:11779-2266
Mailing Address - Country:US
Mailing Address - Phone:631-252-5740
Mailing Address - Fax:631-743-9983
Practice Address - Street 1:127 GATELOT AVE
Practice Address - Street 2:
Practice Address - City:RONKONKOMA
Practice Address - State:NY
Practice Address - Zip Code:11779-2266
Practice Address - Country:US
Practice Address - Phone:631-252-5740
Practice Address - Fax:631-743-9983
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-27
Last Update Date:2015-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0779091041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty