| My Therapist Lcsw, Pllc | |
|
2880 Baisley Ave Bronx NY 10461-6117 | |
| (914) 734-2205 | |
| (914) 734-2203 |
| Full Name | My Therapist Lcsw, Pllc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 2880 Baisley Ave, Bronx, New York |
| Authorized Official Name and Position | Denise Dubose Foulkes (PSYCHOTHERAPIST OWNER) |
| Authorized Official Contact | 9147342205 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| My Therapist Lcsw, Pllc 26 Sniffen Mountain Rd Cortlandt Manor NY 10567-6404 Ph: (914) 734-2205 | My Therapist Lcsw, Pllc 2880 Baisley Ave Bronx NY 10461-6117 Ph: (914) 734-2205 |
| NPI Number | 1164624151 |
|---|---|
| Provider Enumeration Date | 06/03/2007 |
| Last Update Date | 12/26/2023 |
| Certification Date | 12/26/2023 |
| Medicare PECOS PAC ID | 9335473818 |
|---|---|
| Medicare Enrollment ID | O20190703001227 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164624151 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | R048253-1 (New York) | Primary |
| Provider Name | Denise Dubose Foulkes |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1902014194 PECOS PAC ID: 8527225424 Enrollment ID: I20120203000754 |
| Provider Name | Nicole S Memoli |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1801147483 PECOS PAC ID: 4880920271 Enrollment ID: I20190723002041 |
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