Provider Demographics
NPI:1205322096
Name:NEIL HENRY, LCSW, PC
Entity type:Organization
Organization Name:NEIL HENRY, LCSW, PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SOCIAL WORKER
Authorized Official - Prefix:MR
Authorized Official - First Name:NEIL
Authorized Official - Middle Name:
Authorized Official - Last Name:HENRY
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:516-868-0444
Mailing Address - Street 1:775 BROOKLYN AVE.,
Mailing Address - Street 2:SUITE 112
Mailing Address - City:NORTH BALDWIN
Mailing Address - State:NY
Mailing Address - Zip Code:11510-2948
Mailing Address - Country:US
Mailing Address - Phone:516-868-0444
Mailing Address - Fax:360-272-0444
Practice Address - Street 1:775 BROOKLYN AVE.,
Practice Address - Street 2:SUITE 112
Practice Address - City:NORTH BALDWIN
Practice Address - State:NY
Practice Address - Zip Code:11510-2948
Practice Address - Country:US
Practice Address - Phone:516-868-0444
Practice Address - Fax:360-272-0444
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-05
Last Update Date:2018-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty