Smithtown Psychotherapy, Lcsw Pllc | |
285 Middle Country Road Suite Ll5 Smithtown NY 11787 | |
(631) 724-0600 | |
(631) 724-0606 |
Full Name | Smithtown Psychotherapy, Lcsw Pllc |
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Speciality | Counselor |
Location | 285 Middle Country Road, Smithtown, New York |
Authorized Official Name and Position | Elma Pisano (PRESIDENT) |
Authorized Official Contact | 6317240600 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Smithtown Psychotherapy, Lcsw Pllc 26 Violet Rd Kings Park NY 11754-2335 Ph: (631) 724-0600 | Smithtown Psychotherapy, Lcsw Pllc 285 Middle Country Road Suite Ll5 Smithtown NY 11787 Ph: (631) 724-0600 |
NPI Number | 1942633029 |
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Provider Enumeration Date | 08/13/2013 |
Last Update Date | 11/20/2020 |
Certification Date | 11/20/2020 |
Medicare PECOS PAC ID | 3870843469 |
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Medicare Enrollment ID | O20180831000434 |
Identifier | Type | State | Issuer |
---|---|---|---|
1942633029 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
Provider Name | Elma G Pisano |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1851491856 PECOS PAC ID: 2860532009 Enrollment ID: I20091218000079 |
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