| Kontos Psychotherapy Lcsw Pc | |
|
183 S Wellwood Ave Ste. C Lindenhurst NY 11757-4935 | |
| (631) 592-2179 | |
| (631) 592-8060 |
| Full Name | Kontos Psychotherapy Lcsw Pc |
|---|---|
| Speciality | Social Worker |
| Location | 183 S Wellwood Ave, Lindenhurst, New York |
| Authorized Official Name and Position | Kallirroy Kontos (OWNER) |
| Authorized Official Contact | 6315922179 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kontos Psychotherapy Lcsw Pc Po Box 872 Lindenhurst NY 11757-0872 Ph: (631) 592-2179 | Kontos Psychotherapy Lcsw Pc 183 S Wellwood Ave Ste. C Lindenhurst NY 11757-4935 Ph: (631) 592-2179 |
| NPI Number | 1295062693 |
|---|---|
| Provider Enumeration Date | 11/06/2009 |
| Last Update Date | 07/30/2015 |
| Medicare PECOS PAC ID | 3476794504 |
|---|---|
| Medicare Enrollment ID | O20130801000072 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295062693 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Kallirroy Kontos |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1477793313 PECOS PAC ID: 9335035005 Enrollment ID: I20040227000698 |
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