Provider Demographics
NPI:1356976476
Name:LICHTENBERG PSYCHOLOGY SERVICES, PLLC
Entity type:Organization
Organization Name:LICHTENBERG PSYCHOLOGY SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:A
Authorized Official - Last Name:ZURNDORFER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:646-284-6008
Mailing Address - Street 1:276 5TH AVE RM 1101
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001-4544
Mailing Address - Country:US
Mailing Address - Phone:646-284-6008
Mailing Address - Fax:
Practice Address - Street 1:276 5TH AVE RM 1101
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-4544
Practice Address - Country:US
Practice Address - Phone:646-284-6008
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-09
Last Update Date:2020-03-09
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