Provider Demographics
NPI:1649905134
Name:FOUNDATIONS THERAPY, LCSW, PLLC
Entity type:Organization
Organization Name:FOUNDATIONS THERAPY, LCSW, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SOCIAL WORKER
Authorized Official - Prefix:MS
Authorized Official - First Name:JILLIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:DIPIETRO
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:917-310-3083
Mailing Address - Street 1:60 REMSEN ST
Mailing Address - Street 2:PROF SUITE
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11201-3453
Mailing Address - Country:US
Mailing Address - Phone:917-310-3083
Mailing Address - Fax:
Practice Address - Street 1:60 REMSEN ST
Practice Address - Street 2:PROF SUITE
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-3453
Practice Address - Country:US
Practice Address - Phone:917-310-3083
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-19
Last Update Date:2022-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty