| Love Inspires Psychotherapy Lcsw P.c. | |
|
100 Broadhollow Rd Ste 317 Farmingdale NY 11735-4813 | |
| (516) 600-0440 | |
| Not Available |
| Full Name | Love Inspires Psychotherapy Lcsw P.c. |
|---|---|
| Speciality | Social Worker |
| Location | 100 Broadhollow Rd Ste 317, Farmingdale, New York |
| Authorized Official Name and Position | Nashon Clark (OWNER) |
| Authorized Official Contact | 5166000440 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Love Inspires Psychotherapy Lcsw P.c. 100 Broadhollow Rd Ste 317 Farmingdale NY 11735-4813 Ph: (516) 600-0440 | Love Inspires Psychotherapy Lcsw P.c. 100 Broadhollow Rd Ste 317 Farmingdale NY 11735-4813 Ph: (516) 600-0440 |
| NPI Number | 1588231773 |
|---|---|
| Provider Enumeration Date | 06/07/2021 |
| Last Update Date | 06/11/2021 |
| Certification Date | 06/11/2021 |
| Medicare PECOS PAC ID | 3476957945 |
|---|---|
| Medicare Enrollment ID | O20210805000249 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588231773 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Nashon Clark |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1447767371 PECOS PAC ID: 4385905777 Enrollment ID: I20180227002302 |
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