Provider Demographics
NPI:1972328201
Name:NEW YORK YOUTH LCSW SERVICES, PLLC
Entity type:Organization
Organization Name:NEW YORK YOUTH LCSW SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COMPLIANCE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:BUEHRER
Authorized Official - Suffix:
Authorized Official - Credentials:LSW
Authorized Official - Phone:814-661-6870
Mailing Address - Street 1:121 CHANLON RD
Mailing Address - Street 2:
Mailing Address - City:NEW PROVIDENCE
Mailing Address - State:NJ
Mailing Address - Zip Code:07974-1543
Mailing Address - Country:US
Mailing Address - Phone:973-299-9954
Mailing Address - Fax:
Practice Address - Street 1:85 WHEELER RD
Practice Address - Street 2:
Practice Address - City:CENTRAL ISLIP
Practice Address - State:NY
Practice Address - Zip Code:11722-2028
Practice Address - Country:US
Practice Address - Phone:814-661-6870
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-21
Last Update Date:2024-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health