| L I Counseling & Social Work Pc | |
|
3187 Ann St Baldwin NY 11510-4509 | |
| (516) 236-9111 | |
| (516) 223-0332 |
| Full Name | L I Counseling & Social Work Pc |
|---|---|
| Speciality | Social Worker |
| Location | 3187 Ann St, Baldwin, New York |
| Authorized Official Name and Position | Jackie Lynn Zuckerman (PRESIDENT) |
| Authorized Official Contact | 5162369111 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| L I Counseling & Social Work Pc 3187 Ann St Baldwin NY 11510-4509 Ph: (516) 236-9111 | L I Counseling & Social Work Pc 3187 Ann St Baldwin NY 11510-4509 Ph: (516) 236-9111 |
| NPI Number | 1699289835 |
|---|---|
| Provider Enumeration Date | 11/27/2017 |
| Last Update Date | 04/24/2024 |
| Certification Date | 04/24/2024 |
| Medicare PECOS PAC ID | 8820356736 |
|---|---|
| Medicare Enrollment ID | O20171226001786 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699289835 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | R031960-1 (New York) | Primary |
| Provider Name | Jackie L Zuckerman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1568544484 PECOS PAC ID: 0547528226 Enrollment ID: I20180102000320 |
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