Sambal Psychotherapy Lcsw Pllc | |
8003 246th St Bellerose NY 11426-1821 | |
(646) 270-6223 | |
Not Available |
Full Name | Sambal Psychotherapy Lcsw Pllc |
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Speciality | Social Worker |
Location | 8003 246th St, Bellerose, New York |
Authorized Official Name and Position | Dolly Thomas (LICENSED CLINICAL SOCIAL WORKER) |
Authorized Official Contact | 6462706223 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Sambal Psychotherapy Lcsw Pllc 8003 246th St Bellerose NY 11426-1821 Ph: () - | Sambal Psychotherapy Lcsw Pllc 8003 246th St Bellerose NY 11426-1821 Ph: (646) 270-6223 |
NPI Number | 1316687395 |
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Provider Enumeration Date | 03/29/2022 |
Last Update Date | 03/29/2022 |
Certification Date | 03/29/2022 |
Medicare PECOS PAC ID | 2668869942 |
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Medicare Enrollment ID | O20220505001252 |
Identifier | Type | State | Issuer |
---|---|---|---|
1316687395 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
104100000X | Social Worker | (* (Not Available)) | Primary |
Provider Name | Dolly Thomas |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1154725026 PECOS PAC ID: 6103239504 Enrollment ID: I20210104000193 |
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