Provider Demographics
NPI:1013339340
Name:COMPASSIONATE COUNSELING COLLECTIVE
Entity Type:Organization
Organization Name:COMPASSIONATE COUNSELING COLLECTIVE
Other - Org Name:ELIZABETH DUDDY NAVARETTA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR AND LCSWR
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:DUDDY-NAVARETTA
Authorized Official - Suffix:
Authorized Official - Credentials:LCSWR
Authorized Official - Phone:631-988-3559
Mailing Address - Street 1:41 OLEETA RD
Mailing Address - Street 2:
Mailing Address - City:MOUNT SINAI
Mailing Address - State:NY
Mailing Address - Zip Code:11766-2504
Mailing Address - Country:US
Mailing Address - Phone:631-988-3559
Mailing Address - Fax:631-331-5534
Practice Address - Street 1:538 ROUTE 25A
Practice Address - Street 2:SUITE 5
Practice Address - City:ROCKY POINT
Practice Address - State:NY
Practice Address - Zip Code:11778-9089
Practice Address - Country:US
Practice Address - Phone:631-988-3559
Practice Address - Fax:631-331-5534
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-06
Last Update Date:2014-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0502011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYNPI 1427129048OtherNPI
1427129048OtherNPI SOLE PROPRIETOR