Proactive Counseling Lcsw P.c. | |
775 Brooklyn Ave North Baldwin NY 11510-2948 | |
(917) 826-1644 | |
(516) 704-2058 |
Full Name | Proactive Counseling Lcsw P.c. |
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Speciality | Social Worker |
Location | 775 Brooklyn Ave, North Baldwin, New York |
Authorized Official Name and Position | Lea M Boriskin (OWNER) |
Authorized Official Contact | 9178261644 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Proactive Counseling Lcsw P.c. 446 Walton St West Hempstead NY 11552-3051 Ph: (917) 826-1644 | Proactive Counseling Lcsw P.c. 775 Brooklyn Ave North Baldwin NY 11510-2948 Ph: (917) 826-1644 |
NPI Number | 1700318847 |
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Provider Enumeration Date | 03/29/2017 |
Last Update Date | 03/29/2017 |
Medicare PECOS PAC ID | 0648540013 |
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Medicare Enrollment ID | O20170718000193 |
Identifier | Type | State | Issuer |
---|---|---|---|
1700318847 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | 078617 (New York) | Primary |
Provider Name | Lea Boriskin |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1154571396 PECOS PAC ID: 9739347311 Enrollment ID: I20120229000125 |
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