| Social Therapy Contractor Lcsw Llc | |
|
17 Devon Pl Staten Island NY 10301-2012 | |
| (718) 720-0174 | |
| Not Available |
| Full Name | Social Therapy Contractor Lcsw Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 17 Devon Pl, Staten Island, New York |
| Authorized Official Name and Position | Terry J Blocker (CEO) |
| Authorized Official Contact | 7187200174 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Social Therapy Contractor Lcsw Llc 17 Devon Pl Staten Island NY 10301-2012 Ph: (718) 720-0174 | Social Therapy Contractor Lcsw Llc 17 Devon Pl Staten Island NY 10301-2012 Ph: (718) 720-0174 |
| NPI Number | 1457885329 |
|---|---|
| Provider Enumeration Date | 04/17/2017 |
| Last Update Date | 04/17/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457885329 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | R046837-1 (New York) | Primary |
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