Provider Demographics
NPI:1932405016
Name:FAMILY HARMONYAND PERSONAL GROWTH LCSW PC
Entity Type:Organization
Organization Name:FAMILY HARMONYAND PERSONAL GROWTH LCSW PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:W
Authorized Official - Last Name:BANKS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:631-654-8101
Mailing Address - Street 1:140 N OCEAN AVE
Mailing Address - Street 2:
Mailing Address - City:PATCHOGUE
Mailing Address - State:NY
Mailing Address - Zip Code:11772-2023
Mailing Address - Country:US
Mailing Address - Phone:631-654-8101
Mailing Address - Fax:
Practice Address - Street 1:140 N OCEAN AVE
Practice Address - Street 2:
Practice Address - City:PATCHOGUE
Practice Address - State:NY
Practice Address - Zip Code:11772-2023
Practice Address - Country:US
Practice Address - Phone:631-654-8101
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-07
Last Update Date:2011-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR03091911041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty