Provider Demographics
NPI:1013944396
Name:HIGHLAND COUNSELING SERVICES LCSW LLC
Entity Type:Organization
Organization Name:HIGHLAND COUNSELING SERVICES LCSW LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR SOCIAL WORKER
Authorized Official - Prefix:MS
Authorized Official - First Name:GLORIA
Authorized Official - Middle Name:DAWN
Authorized Official - Last Name:LORENTZEN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:845-699-8036
Mailing Address - Street 1:PO BOX 265
Mailing Address - Street 2:
Mailing Address - City:ELDRED
Mailing Address - State:NY
Mailing Address - Zip Code:12732-0265
Mailing Address - Country:US
Mailing Address - Phone:845-699-8036
Mailing Address - Fax:
Practice Address - Street 1:585 RTE. 55
Practice Address - Street 2:
Practice Address - City:ELDRED
Practice Address - State:NY
Practice Address - Zip Code:12732
Practice Address - Country:US
Practice Address - Phone:845-699-8036
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-26
Last Update Date:2010-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP0615191041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty