| Extending Roots Lcsw Pc | |
|
135 Madison Ave New York NY 10016-6712 | |
| (609) 836-0077 | |
| Not Available |
| Full Name | Extending Roots Lcsw Pc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 135 Madison Ave, New York, New York |
| Authorized Official Name and Position | Erica Abramov (CEO/ CLINICAL SOCIAL WORKER) |
| Authorized Official Contact | 6098360077 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Extending Roots Lcsw Pc 21 Pecan Valley Dr Marlboro NJ 07746-2137 Ph: (917) 418-7796 | Extending Roots Lcsw Pc 135 Madison Ave New York NY 10016-6712 Ph: (609) 836-0077 |
| NPI Number | 1326898834 |
|---|---|
| Provider Enumeration Date | 03/26/2024 |
| Last Update Date | 04/16/2024 |
| Certification Date | 04/16/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326898834 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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