Lcsw Interventions For Emotional Growth, Pc | |
14101 68th Dr Suite A Kew Gardens Hills NY 11367-1635 | |
(718) 520-0798 | |
Not Available |
Full Name | Lcsw Interventions For Emotional Growth, Pc |
---|---|
Speciality | Social Worker |
Location | 14101 68th Dr, Kew Gardens Hills, New York |
Authorized Official Name and Position | Monica Brignolo (CLINICAL DIRECTOR) |
Authorized Official Contact | 7185200798 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Lcsw Interventions For Emotional Growth, Pc 14101 68th Dr Suite A Kew Gardens Hills NY 11367-1635 Ph: (718) 520-0798 | Lcsw Interventions For Emotional Growth, Pc 14101 68th Dr Suite A Kew Gardens Hills NY 11367-1635 Ph: (718) 520-0798 |
NPI Number | 1114286101 |
---|---|
Provider Enumeration Date | 05/10/2012 |
Last Update Date | 05/10/2012 |
Medicare PECOS PAC ID | 0749412476 |
---|---|
Medicare Enrollment ID | O20140512000139 |
Identifier | Type | State | Issuer |
---|---|---|---|
1114286101 | NPI | - | NPPES |
9865705 | Other | NY | AETNA PIN |
11699877 | Other | NY | CAQH UNIVERSAL CREDENTIALS |
274655 | Other | NY | MHN PIN |
02864693 | Medicaid | NY | |
000600019133 | Other | NY | HEALTH PLUS/ FAMILY HEALTH PLUS/ CHILD HEALTH PLUS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | RO46222 (New York) | Primary |
Provider Name | Monica Brignolo |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1255342309 PECOS PAC ID: 6800810979 Enrollment ID: I20060117000812 |