| Colonial Youth And Family Services Inc. | |
|
346 Montauk Hwy Ste 1a Moriches NY 11955 | |
| (631) 281-4461 | |
| Not Available |
| Full Name | Colonial Youth And Family Services Inc. |
|---|---|
| Speciality | Social Worker |
| Location | 346 Montauk Hwy Ste 1a, Moriches, New York |
| Authorized Official Name and Position | Lynda Zach (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 6312814461 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Colonial Youth And Family Services Inc. Po Box 391 Mastic Beach NY 11951 Ph: (631) 281-4461 | Colonial Youth And Family Services Inc. 346 Montauk Hwy Ste 1a Moriches NY 11955 Ph: (631) 281-4461 |
| NPI Number | 1043491665 |
|---|---|
| Provider Enumeration Date | 11/26/2007 |
| Last Update Date | 09/06/2018 |
| Medicare PECOS PAC ID | 0244595031 |
|---|---|
| Medicare Enrollment ID | O20180529000199 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043491665 | NPI | - | NPPES |
| 01069570 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 104100000X | Social Worker | 091047 (New York) | Secondary |
| 1041C0700X | Social Worker - Clinical | 083045 (New York) | Primary |
| 251B00000X | Case Management | (New York) | Secondary |
| Provider Name | Kimberly Lynn Andrejkovics |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1386935948 PECOS PAC ID: 0244595684 Enrollment ID: I20180605003174 |
| Provider Name | Paula M Elliott Gilroy |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1073907358 PECOS PAC ID: 2567898471 Enrollment ID: I20200212000457 |