| Theodora Slone Lcsw Llc | |
|
185 Davenport St Lindenhurst NY 11757-5317 | |
| (631) 827-2813 | |
| Not Available |
| Full Name | Theodora Slone Lcsw Llc |
|---|---|
| Speciality | Clinic/center |
| Location | 185 Davenport St, Lindenhurst, New York |
| Authorized Official Name and Position | Theodora Rush Slone (THERAPIST/ OWNER) |
| Authorized Official Contact | 6318272813 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Theodora Slone Lcsw Llc 185 Davenport St Lindenhurst NY 11757-5317 Ph: (631) 827-2813 | Theodora Slone Lcsw Llc 185 Davenport St Lindenhurst NY 11757-5317 Ph: (631) 827-2813 |
| NPI Number | 1174287130 |
|---|---|
| Provider Enumeration Date | 10/26/2021 |
| Last Update Date | 10/26/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174287130 | NPI | - | NPPES |
| 06711600 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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