Provider Demographics
NPI:1922191246
Name:WOODRICH CONSULTATION CENTER
Entity Type:Organization
Organization Name:WOODRICH CONSULTATION CENTER
Other - Org Name:ANTHONY LERRO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CLINICAL COORDINATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:VINCENT
Authorized Official - Last Name:LERRO
Authorized Official - Suffix:
Authorized Official - Credentials:CSW
Authorized Official - Phone:516-379-0525
Mailing Address - Street 1:1971 DE KALB AVE
Mailing Address - Street 2:
Mailing Address - City:MERRICK
Mailing Address - State:NY
Mailing Address - Zip Code:11566-2602
Mailing Address - Country:US
Mailing Address - Phone:516-379-0525
Mailing Address - Fax:516-379-2772
Practice Address - Street 1:9749 WOODHAVEN BLVD
Practice Address - Street 2:
Practice Address - City:OZONE PARK
Practice Address - State:NY
Practice Address - Zip Code:11416-2312
Practice Address - Country:US
Practice Address - Phone:718-845-8481
Practice Address - Fax:516-379-2772
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-30
Last Update Date:2010-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0168441041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty