Provider Demographics
NPI:1740545748
Name:FOLEY, EUGENE T (LCSW)
Entity type:Individual
Prefix:
First Name:EUGENE
Middle Name:T
Last Name:FOLEY
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:755 PARK AVE
Mailing Address - Street 2:SUITE 140
Mailing Address - City:HUNTINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11743-3975
Mailing Address - Country:US
Mailing Address - Phone:631-316-5233
Mailing Address - Fax:
Practice Address - Street 1:755 PARK AVE
Practice Address - Street 2:SUITE 140
Practice Address - City:HUNTINGTON
Practice Address - State:NY
Practice Address - Zip Code:11743-3975
Practice Address - Country:US
Practice Address - Phone:631-316-5233
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-06
Last Update Date:2014-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY078836104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker