Provider Demographics
NPI:1629494273
Name:NYC THERAPY GROUP, LCSWS PSYCHOTHERAPY PROFESSIONALS PLLC
Entity Type:Organization
Organization Name:NYC THERAPY GROUP, LCSWS PSYCHOTHERAPY PROFESSIONALS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:AMIR
Authorized Official - Middle Name:
Authorized Official - Last Name:LEVINE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LCSW, CASAC
Authorized Official - Phone:646-389-5801
Mailing Address - Street 1:5731 MOSHOLU AVE
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10471-2205
Mailing Address - Country:US
Mailing Address - Phone:646-389-5801
Mailing Address - Fax:
Practice Address - Street 1:5731 MOSHOLU AVE
Practice Address - Street 2:2ND FLOOR
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10471-2205
Practice Address - Country:US
Practice Address - Phone:646-389-5801
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-06
Last Update Date:2014-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0744081041C0700X
NY0756691041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1205953163OtherNPI
NY1508989773OtherNPI