| Integrative Care Group Lcsw Pllc | |
|
5914 70th Ave Ridgewood NY 11385-5654 | |
| (917) 725-0621 | |
| Not Available |
| Full Name | Integrative Care Group Lcsw Pllc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 5914 70th Ave, Ridgewood, New York |
| Authorized Official Name and Position | Cesar Vanegas (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 9177250621 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Integrative Care Group Lcsw Pllc 5914 70th Ave Ridgewood NY 11385-5654 Ph: (917) 725-0621 | Integrative Care Group Lcsw Pllc 5914 70th Ave Ridgewood NY 11385-5654 Ph: (917) 725-0621 |
| NPI Number | 1972257038 |
|---|---|
| Provider Enumeration Date | 02/08/2022 |
| Last Update Date | 03/21/2022 |
| Certification Date | 03/21/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972257038 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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