Provider Demographics
NPI:1942448527
Name:FIFTH AVENUE CENTER FOR COUNSELING AND PSYCHOTHERAPY, INC.
Entity Type:Organization
Organization Name:FIFTH AVENUE CENTER FOR COUNSELING AND PSYCHOTHERAPY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JERRY
Authorized Official - Middle Name:M
Authorized Official - Last Name:WEBER
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:212-989-2990
Mailing Address - Street 1:50 W 23RD ST
Mailing Address - Street 2:9TH FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10010-5205
Mailing Address - Country:US
Mailing Address - Phone:212-989-0990
Mailing Address - Fax:212-792-6058
Practice Address - Street 1:50 W 23RD ST
Practice Address - Street 2:9TH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-5205
Practice Address - Country:US
Practice Address - Phone:212-989-0990
Practice Address - Fax:212-792-6058
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-04
Last Update Date:2009-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health