Provider Demographics
NPI:1477351773
Name:MOMENTUM COUNSELING SERVICES LCSW, PLLC
Entity type:Organization
Organization Name:MOMENTUM COUNSELING SERVICES LCSW, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:PICA
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LCSW, CASAC-2
Authorized Official - Phone:631-923-7431
Mailing Address - Street 1:203 SMITH AVE
Mailing Address - Street 2:
Mailing Address - City:HOLBROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11741-1150
Mailing Address - Country:US
Mailing Address - Phone:631-371-4305
Mailing Address - Fax:
Practice Address - Street 1:25 MELVILLE PARK RD STE 110B
Practice Address - Street 2:
Practice Address - City:MELVILLE
Practice Address - State:NY
Practice Address - Zip Code:11747-3182
Practice Address - Country:US
Practice Address - Phone:631-371-4305
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-04
Last Update Date:2025-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty