Provider Demographics
NPI:1851065064
Name:COMMUNITY CONCERN LCSW SERVICES, PC
Entity Type:Organization
Organization Name:COMMUNITY CONCERN LCSW SERVICES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:TRACEY
Authorized Official - Middle Name:D
Authorized Official - Last Name:LITTLE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:646-671-7581
Mailing Address - Street 1:20417 HILLSIDE AVE STE 332
Mailing Address - Street 2:
Mailing Address - City:HOLLIS
Mailing Address - State:NY
Mailing Address - Zip Code:11423-2213
Mailing Address - Country:US
Mailing Address - Phone:646-671-7581
Mailing Address - Fax:
Practice Address - Street 1:13420 87TH AVE APT 4D
Practice Address - Street 2:
Practice Address - City:RICHMOND HILL
Practice Address - State:NY
Practice Address - Zip Code:11418-1905
Practice Address - Country:US
Practice Address - Phone:646-671-7581
Practice Address - Fax:646-968-9975
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-03
Last Update Date:2021-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health