Provider Demographics
NPI:1598153629
Name:LIFESKILLS COUNSELING SERVICES LCSW, PC
Entity Type:Organization
Organization Name:LIFESKILLS COUNSELING SERVICES LCSW, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARIANA
Authorized Official - Middle Name:C
Authorized Official - Last Name:LOPEZ
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:917-597-3821
Mailing Address - Street 1:372 ARKANSAS DR
Mailing Address - Street 2:
Mailing Address - City:VALLEY STREAM
Mailing Address - State:NY
Mailing Address - Zip Code:11580-1804
Mailing Address - Country:US
Mailing Address - Phone:917-597-3821
Mailing Address - Fax:516-837-3073
Practice Address - Street 1:4612 QUEENS BLVD
Practice Address - Street 2:209A
Practice Address - City:SUNNYSIDE
Practice Address - State:NY
Practice Address - Zip Code:11104-1740
Practice Address - Country:US
Practice Address - Phone:917-597-3821
Practice Address - Fax:516-837-3073
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-23
Last Update Date:2014-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY081425251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health