| Ajsl Counseling And Therapy Services Inc. | |
|
2520 Humphrey St East Elmhurst NY 11369-1621 | |
| (718) 757-4054 | |
| (718) 446-3732 |
| Full Name | Ajsl Counseling And Therapy Services Inc. |
|---|---|
| Speciality | Social Worker |
| Location | 2520 Humphrey St, East Elmhurst, New York |
| Authorized Official Name and Position | Shirley Smith (CEO) |
| Authorized Official Contact | 7184463732 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ajsl Counseling And Therapy Services Inc. 9107 25th Ave P.o. Box 690225 East Elmhurst NY 11369 Ph: (718) 757-4054 | Ajsl Counseling And Therapy Services Inc. 2520 Humphrey St East Elmhurst NY 11369-1621 Ph: (718) 757-4054 |
| NPI Number | 1538749676 |
|---|---|
| Provider Enumeration Date | 04/13/2021 |
| Last Update Date | 04/13/2021 |
| Certification Date | 12/04/2020 |
| Medicare PECOS PAC ID | 4789093337 |
|---|---|
| Medicare Enrollment ID | O20210511002009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538749676 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Shirley Smith |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1770950834 PECOS PAC ID: 8921417577 Enrollment ID: I20210511002516 |
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