| Mychattherapist Lcsw Pllc | |
|
666 Onderdonk Ave Ridgewood NY 11385-2207 | |
| (718) 926-3170 | |
| Not Available |
| Full Name | Mychattherapist Lcsw Pllc |
|---|---|
| Speciality | Counselor |
| Location | 666 Onderdonk Ave, Ridgewood, New York |
| Authorized Official Name and Position | Enrique Rodriguez (CLINICAL THERAPIST) |
| Authorized Official Contact | 7189263170 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mychattherapist Lcsw Pllc 666 Onderdonk Ave #1 Ridgewood NY 11385-2207 Ph: (718) 926-3170 | Mychattherapist Lcsw Pllc 666 Onderdonk Ave Ridgewood NY 11385-2207 Ph: (718) 926-3170 |
| NPI Number | 1770871469 |
|---|---|
| Provider Enumeration Date | 07/14/2011 |
| Last Update Date | 07/14/2011 |
| Medicare PECOS PAC ID | 6305183849 |
|---|---|
| Medicare Enrollment ID | O20190123000043 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770871469 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | R055338 (New York) | Primary |
| Provider Name | Elizabeth Franqui |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1659500635 PECOS PAC ID: 9537406079 Enrollment ID: I20190123000176 |
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