| Genie Portillo Lcsw-r, Casc | |
|
16 Library Ave Ste B Westhampton Beach NY 11978-2664 | |
| (631) 998-4644 | |
| Not Available |
| Full Name | Genie Portillo Lcsw-r, Casc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 16 Library Ave Ste B, Westhampton Beach, New York |
| Authorized Official Name and Position | Genie Portillo (OWNER) |
| Authorized Official Contact | 6319984644 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Genie Portillo Lcsw-r, Casc 16 Library Ave Ste B Westhampton Beach NY 11978-2664 Ph: (631) 998-4644 | Genie Portillo Lcsw-r, Casc 16 Library Ave Ste B Westhampton Beach NY 11978-2664 Ph: (631) 998-4644 |
| NPI Number | 1508448465 |
|---|---|
| Provider Enumeration Date | 04/21/2021 |
| Last Update Date | 04/21/2021 |
| Certification Date | 04/17/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508448465 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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