| Mental Health Providers Of Western Queens | |
|
3708 91st St Suite 3a Jackson Heights NY 11372-7928 | |
| (718) 779-2263 | |
| (718) 779-2225 |
| Full Name | Mental Health Providers Of Western Queens |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 3708 91st St, Jackson Heights, New York |
| Authorized Official Name and Position | Katherine Laing Ambia (CLINICIAN) |
| Authorized Official Contact | 9175663754 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mental Health Providers Of Western Queens 213 Taaffe Pl Apt. 214 Brooklyn NY 11205-4378 Ph: (917) 566-3754 | Mental Health Providers Of Western Queens 3708 91st St Suite 3a Jackson Heights NY 11372-7928 Ph: (718) 779-2263 |
| NPI Number | 1104200294 |
|---|---|
| Provider Enumeration Date | 07/17/2015 |
| Last Update Date | 07/17/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104200294 | NPI | - | NPPES |
| 094706 | Other | NY | LMSW LICENSE NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 094706 (New York) | Primary |
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