Provider Demographics
NPI:1942083159
Name:POSILLICO COUNSELING LICENSED CLINICAL SOCIAL WORK PLLC
Entity Type:Organization
Organization Name:POSILLICO COUNSELING LICENSED CLINICAL SOCIAL WORK PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:K
Authorized Official - Last Name:POSILLICO
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:631-673-5433
Mailing Address - Street 1:17 EAST CARVER STREET
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11743
Mailing Address - Country:US
Mailing Address - Phone:631-673-5433
Mailing Address - Fax:631-673-5435
Practice Address - Street 1:17 EAST CARVER STREET
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:NY
Practice Address - Zip Code:11743
Practice Address - Country:US
Practice Address - Phone:631-673-5433
Practice Address - Fax:631-673-5435
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-14
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty