Provider Demographics
NPI:1922164029
Name:FLUG, HARRIS MICHAEL (LCSW-R)
Entity Type:Individual
Prefix:MR
First Name:HARRIS
Middle Name:MICHAEL
Last Name:FLUG
Suffix:
Gender:M
Credentials:LCSW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43 CEDAR VALLEY LN
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11743-1807
Mailing Address - Country:US
Mailing Address - Phone:631-357-2225
Mailing Address - Fax:
Practice Address - Street 1:43 CEDAR VALLEY LN
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:NY
Practice Address - Zip Code:11743-1807
Practice Address - Country:US
Practice Address - Phone:631-357-2225
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0346231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY8668370241Medicaid
NYN1H 901Medicare ID - Type Unspecified
NY8668370241Medicaid