Provider Demographics
NPI:1629677661
Name:CONCERN4COMMUNITY LCSW SERVICES PLLC
Entity Type:Organization
Organization Name:CONCERN4COMMUNITY LCSW SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TRACEY
Authorized Official - Middle Name:
Authorized Official - Last Name:LITTLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:646-671-7581
Mailing Address - Street 1:20417 HILLSIDE AVE STE 33
Mailing Address - Street 2:
Mailing Address - City:HOLLIS
Mailing Address - State:NY
Mailing Address - Zip Code:11423-2213
Mailing Address - Country:US
Mailing Address - Phone:646-671-7581
Mailing Address - Fax:
Practice Address - Street 1:13420 87TH AVE
Practice Address - Street 2:
Practice Address - City:RICHMOND HILL
Practice Address - State:NY
Practice Address - Zip Code:11418-1953
Practice Address - Country:US
Practice Address - Phone:646-671-7581
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-21
Last Update Date:2020-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty