Provider Demographics
NPI:1689147423
Name:EMPIRE STATE FORENSICS, LCSW P.C.
Entity Type:Organization
Organization Name:EMPIRE STATE FORENSICS, LCSW P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:J
Authorized Official - Last Name:LAU
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:914-341-2039
Mailing Address - Street 1:280 NORTH CENTRAL AVENUE
Mailing Address - Street 2:SUITE 40
Mailing Address - City:HARTSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10530
Mailing Address - Country:US
Mailing Address - Phone:914-341-2039
Mailing Address - Fax:914-517-1356
Practice Address - Street 1:280 NORTH CENTRAL AVENUE
Practice Address - Street 2:SUITE 40
Practice Address - City:HARTSDALE
Practice Address - State:NY
Practice Address - Zip Code:10530
Practice Address - Country:US
Practice Address - Phone:914-341-2039
Practice Address - Fax:914-517-1356
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-04
Last Update Date:2019-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty