Provider Demographics
NPI:1841798881
Name:LEXINGTON PSYCHOTHERAPY LCSW PLLC
Entity Type:Organization
Organization Name:LEXINGTON PSYCHOTHERAPY LCSW PLLC
Other - Org Name:SOFIA DISANTI
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SOFIA
Authorized Official - Middle Name:
Authorized Official - Last Name:FRANK
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-R
Authorized Official - Phone:347-670-4479
Mailing Address - Street 1:315 MADISON AVE RM 506
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10017-5436
Mailing Address - Country:US
Mailing Address - Phone:347-670-4479
Mailing Address - Fax:
Practice Address - Street 1:315 MADISON AVE
Practice Address - Street 2:RM 506
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017-5436
Practice Address - Country:US
Practice Address - Phone:347-670-4479
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-24
Last Update Date:2021-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0834241041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty