| Go Forward Psychotherapy Lcsw-r Pllc | |
|
193 Central Ave Bohemia NY 11716-3108 | |
| (631) 848-5470 | |
| Not Available |
| Full Name | Go Forward Psychotherapy Lcsw-r Pllc |
|---|---|
| Speciality | Social Worker |
| Location | 193 Central Ave, Bohemia, New York |
| Authorized Official Name and Position | Jill Brown (OWNER) |
| Authorized Official Contact | 6318485470 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Go Forward Psychotherapy Lcsw-r Pllc 193 Central Ave Bohemia NY 11716-3108 Ph: (631) 848-5470 | Go Forward Psychotherapy Lcsw-r Pllc 193 Central Ave Bohemia NY 11716-3108 Ph: (631) 848-5470 |
| NPI Number | 1871125971 |
|---|---|
| Provider Enumeration Date | 02/06/2020 |
| Last Update Date | 02/06/2020 |
| Certification Date | 02/06/2020 |
| Medicare PECOS PAC ID | 3870936909 |
|---|---|
| Medicare Enrollment ID | O20240206002545 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871125971 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Jill Brown |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1861765356 PECOS PAC ID: 6507026143 Enrollment ID: I20120320000193 |
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