Provider Demographics
NPI:1851762165
Name:BOSK, AMY (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:
Last Name:BOSK
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3051 36TH ST
Mailing Address - Street 2:
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11103-4704
Mailing Address - Country:US
Mailing Address - Phone:347-732-3549
Mailing Address - Fax:718-440-8460
Practice Address - Street 1:3051 36TH ST
Practice Address - Street 2:
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11103-4704
Practice Address - Country:US
Practice Address - Phone:347-732-3549
Practice Address - Fax:718-440-8460
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-13
Last Update Date:2015-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0790361041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical