Provider Demographics
NPI:1831336759
Name:PYSCHOTHERAPY AND SOCIAL WORK CONCEPTS PC
Entity type:Organization
Organization Name:PYSCHOTHERAPY AND SOCIAL WORK CONCEPTS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LCSWR
Authorized Official - Prefix:MS
Authorized Official - First Name:BONNIE
Authorized Official - Middle Name:DALE
Authorized Official - Last Name:HALEY
Authorized Official - Suffix:
Authorized Official - Credentials:LCSWR
Authorized Official - Phone:631-744-7009
Mailing Address - Street 1:19 ZENITH RD
Mailing Address - Street 2:
Mailing Address - City:ROCKY POINT
Mailing Address - State:NY
Mailing Address - Zip Code:11778-8844
Mailing Address - Country:US
Mailing Address - Phone:631-744-7009
Mailing Address - Fax:631-744-7009
Practice Address - Street 1:19 ZENITH RD
Practice Address - Street 2:
Practice Address - City:ROCKY POINT
Practice Address - State:NY
Practice Address - Zip Code:11778-8844
Practice Address - Country:US
Practice Address - Phone:631-744-7009
Practice Address - Fax:631-744-7009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-14
Last Update Date:2019-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center