| Suffolk Family Therapy Lcsw Pc | |
|
606 Johnson Ave Ste 34 Bohemia NY 11716-2689 | |
| (631) 503-1539 | |
| Not Available |
| Full Name | Suffolk Family Therapy Lcsw Pc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 606 Johnson Ave Ste 34, Bohemia, New York |
| Authorized Official Name and Position | Jamie K Vollmoeller (PRESIDENT) |
| Authorized Official Contact | 6315031539 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Suffolk Family Therapy Lcsw Pc 7 Lehigh Ln Farmingville NY 11738-1421 Ph: (531) 503-1539 | Suffolk Family Therapy Lcsw Pc 606 Johnson Ave Ste 34 Bohemia NY 11716-2689 Ph: (631) 503-1539 |
| NPI Number | 1356977177 |
|---|---|
| Provider Enumeration Date | 03/13/2020 |
| Last Update Date | 03/13/2020 |
| Certification Date | 03/13/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356977177 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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