| Dynamic Counseling Lcsw Pc | |
|
354 Veterans Memorial Hwy Ste 5 Commack NY 11725-4331 | |
| (516) 324-6823 | |
| Not Available |
| Full Name | Dynamic Counseling Lcsw Pc |
|---|---|
| Speciality | Counselor |
| Location | 354 Veterans Memorial Hwy Ste 5, Commack, New York |
| Authorized Official Name and Position | James Sharpe (CO PRESIDENT) |
| Authorized Official Contact | 5163246823 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dynamic Counseling Lcsw Pc 354 Veterans Hwy Ste 5 Commack NY 11725-4331 Ph: (516) 324-6823 | Dynamic Counseling Lcsw Pc 354 Veterans Memorial Hwy Ste 5 Commack NY 11725-4331 Ph: (516) 324-6823 |
| NPI Number | 1457949562 |
|---|---|
| Provider Enumeration Date | 01/05/2021 |
| Last Update Date | 01/05/2021 |
| Certification Date | 01/05/2021 |
| Medicare PECOS PAC ID | 2163839135 |
|---|---|
| Medicare Enrollment ID | O20210319000330 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457949562 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Maya Novok |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1073806980 PECOS PAC ID: 1153540455 Enrollment ID: I20140918002278 |
| Provider Name | James S. Sharpe |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1124429519 PECOS PAC ID: 1456616788 Enrollment ID: I20180607000750 |
| Provider Name | Michael A Iacovelli |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1245663293 PECOS PAC ID: 1557797065 Enrollment ID: I20200131001364 |
| Provider Name | Brittany M Decker |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1275045577 PECOS PAC ID: 1355729963 Enrollment ID: I20220609000566 |
| Provider Name | Chloe Lemza |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1861010530 PECOS PAC ID: 9335511278 Enrollment ID: I20230202001555 |
| Provider Name | Christina T Murphy |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1750786372 PECOS PAC ID: 8921454729 Enrollment ID: I20231031002059 |
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