Provider Demographics
NPI:1801667662
Name:PANORA THERAPY LCSW, PLLC
Entity type:Organization
Organization Name:PANORA THERAPY LCSW, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER-MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ELIANA
Authorized Official - Middle Name:M
Authorized Official - Last Name:PANORA
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:718-808-6287
Mailing Address - Street 1:169 COMMACK RD # 1058
Mailing Address - Street 2:
Mailing Address - City:COMMACK
Mailing Address - State:NY
Mailing Address - Zip Code:11725-3442
Mailing Address - Country:US
Mailing Address - Phone:718-808-6287
Mailing Address - Fax:
Practice Address - Street 1:169 COMMACK RD # 1058
Practice Address - Street 2:
Practice Address - City:COMMACK
Practice Address - State:NY
Practice Address - Zip Code:11725-3442
Practice Address - Country:US
Practice Address - Phone:718-808-6287
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-10
Last Update Date:2024-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty