Provider Demographics
NPI:1821341454
Name:PROFESSIONAL COUNSELING SERVICES LCSW PLLC
Entity Type:Organization
Organization Name:PROFESSIONAL COUNSELING SERVICES LCSW PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MEMBER LLC
Authorized Official - Prefix:
Authorized Official - First Name:ELLEN
Authorized Official - Middle Name:
Authorized Official - Last Name:VERNY
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-R
Authorized Official - Phone:917-420-0301
Mailing Address - Street 1:155 OCEANA DR. E
Mailing Address - Street 2:#6F
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235
Mailing Address - Country:US
Mailing Address - Phone:917-420-0301
Mailing Address - Fax:718-676-4892
Practice Address - Street 1:1009 BRIGHTON BEACH AVE
Practice Address - Street 2:3RD FL.
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235
Practice Address - Country:US
Practice Address - Phone:917-420-0301
Practice Address - Fax:718-676-4892
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-19
Last Update Date:2015-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0556831041C0700X
1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty