| Port Counseling Center Inc | |
|
225 Main St Port Washington NY 11050-3211 | |
| (516) 767-1133 | |
| (516) 767-3680 |
| Full Name | Port Counseling Center Inc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 225 Main St, Port Washington, New York |
| Authorized Official Name and Position | Agnes Lasetchuk (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 5167671133 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Port Counseling Center Inc 225 Main St Port Washington NY 11050-3211 Ph: (516) 767-1133 | Port Counseling Center Inc 225 Main St Port Washington NY 11050-3211 Ph: (516) 767-1133 |
| NPI Number | 1215025366 |
|---|---|
| Provider Enumeration Date | 10/11/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215025366 | NPI | - | NPPES |
| 02760429 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (New York) | Primary |
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