Provider Demographics
NPI:1255162889
Name:NEAL SANTACRUZ LCSW PLLC
Entity type:Organization
Organization Name:NEAL SANTACRUZ LCSW PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NEAL
Authorized Official - Middle Name:
Authorized Official - Last Name:SANTACRUZ
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:917-957-6958
Mailing Address - Street 1:4601 GREENPOINT AVE APT 2C
Mailing Address - Street 2:
Mailing Address - City:SUNNYSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11104-1786
Mailing Address - Country:US
Mailing Address - Phone:917-957-6958
Mailing Address - Fax:
Practice Address - Street 1:4601 GREENPOINT AVE APT 2C
Practice Address - Street 2:
Practice Address - City:SUNNYSIDE
Practice Address - State:NY
Practice Address - Zip Code:11104-1786
Practice Address - Country:US
Practice Address - Phone:917-957-6958
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-14
Last Update Date:2024-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty