| Confidential Lcsw Services,p.c. | |
|
3047 Brighton 14th St 2nd Floor Brooklyn NY 11235-5501 | |
| (917) 544-5473 | |
| Not Available |
| Full Name | Confidential Lcsw Services,p.c. |
|---|---|
| Speciality | Social Worker |
| Location | 3047 Brighton 14th St, Brooklyn, New York |
| Authorized Official Name and Position | Tatyana Shahova (PRESIDENT) |
| Authorized Official Contact | 9175445473 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Confidential Lcsw Services,p.c. 3047 Brighton 14th St 2nd Floor Brooklyn NY 11235-5501 Ph: (917) 544-5473 | Confidential Lcsw Services,p.c. 3047 Brighton 14th St 2nd Floor Brooklyn NY 11235-5501 Ph: (917) 544-5473 |
| NPI Number | 1235664491 |
|---|---|
| Provider Enumeration Date | 04/25/2017 |
| Last Update Date | 04/25/2017 |
| Medicare PECOS PAC ID | 5294148441 |
|---|---|
| Medicare Enrollment ID | O20210106002622 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235664491 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 084662 (New York) | Primary |
| Provider Name | Tatyana Shahova |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1033429188 PECOS PAC ID: 2466735311 Enrollment ID: I20170301001589 |
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