| Innovative Counseling Lcsw Pllc | |
|
2127 Crompond Rd Ste 102 Cortlandt Manor NY 10567-4334 | |
| (914) 788-8400 | |
| (914) 788-6781 |
| Full Name | Innovative Counseling Lcsw Pllc |
|---|---|
| Speciality | Social Worker |
| Location | 2127 Crompond Rd Ste 102, Cortlandt Manor, New York |
| Authorized Official Name and Position | Sandra Serrano (CEO) |
| Authorized Official Contact | 9147888400 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Innovative Counseling Lcsw Pllc 2127 Crompond Rd Ste 102 Cortlandt Manor NY 10567-4328 Ph: (914) 788-8400 | Innovative Counseling Lcsw Pllc 2127 Crompond Rd Ste 102 Cortlandt Manor NY 10567-4334 Ph: (914) 788-8400 |
| NPI Number | 1770727182 |
|---|---|
| Provider Enumeration Date | 04/29/2009 |
| Last Update Date | 09/14/2017 |
| Medicare PECOS PAC ID | 8729350905 |
|---|---|
| Medicare Enrollment ID | O20170823001302 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770727182 | NPI | - | NPPES |
| 02266966 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 73-069744 (New York) | Primary |
| Provider Name | Sandra Serrano |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1093781221 PECOS PAC ID: 2961490222 Enrollment ID: I20040504001754 |
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