Provider Demographics
NPI:1881164564
Name:MASLOWSKI, ADAM CHRISTOPHER (LCSW)
Entity type:Individual
Prefix:
First Name:ADAM
Middle Name:CHRISTOPHER
Last Name:MASLOWSKI
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34-11 VERNON BLVD.
Mailing Address - Street 2:
Mailing Address - City:LONG ISLAND CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11106
Mailing Address - Country:US
Mailing Address - Phone:646-505-2003
Mailing Address - Fax:
Practice Address - Street 1:34-11 VERNON BLVD.
Practice Address - Street 2:
Practice Address - City:LONG ISLAND CITY
Practice Address - State:NY
Practice Address - Zip Code:11106
Practice Address - Country:US
Practice Address - Phone:646-505-2003
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-26
Last Update Date:2019-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY096878-1104100000X
NY0884891041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker