| Avatar Counseling Innovations | |
|
660 Main St Port Jefferson NY 11777-2203 | |
| (631) 828-2592 | |
| (631) 509-1839 |
| Full Name | Avatar Counseling Innovations |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 660 Main St, Port Jefferson, New York |
| Authorized Official Name and Position | Joseph Michael Gagliano (PRESIDENT) |
| Authorized Official Contact | 6318282592 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Avatar Counseling Innovations 660 Main St. Port Jefferson NY 11777-2203 Ph: (631) 828-2592 | Avatar Counseling Innovations 660 Main St Port Jefferson NY 11777-2203 Ph: (631) 828-2592 |
| NPI Number | 1750682084 |
|---|---|
| Provider Enumeration Date | 11/03/2010 |
| Last Update Date | 11/03/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750682084 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | R049621-1 (New York) | Primary |
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