Provider Demographics
NPI:1659150035
Name:INTUITIVE PSYCHOTHERAPY EVALUATIONS LCSW PLLC
Entity Type:Organization
Organization Name:INTUITIVE PSYCHOTHERAPY EVALUATIONS LCSW PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SASHA
Authorized Official - Middle Name:
Authorized Official - Last Name:EGA
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:917-847-1096
Mailing Address - Street 1:3811 DITMARS BLVD # 2290
Mailing Address - Street 2:
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11105-2176
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:115 57TH AVE
Practice Address - Street 2:UNIT 3121
Practice Address - City:QUEENS
Practice Address - State:NY
Practice Address - Zip Code:11101
Practice Address - Country:US
Practice Address - Phone:917-847-1096
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-26
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty