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Organization

RESIDENTIAL PSYCHOTHERAPIES,CSW,PC

Active
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Organization

RESIDENTIAL PSYCHOTHERAPIES,CSW,PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. RICHARD NEMIROFF LCSW (CEO)
(631) 366-0417
Entity
Organization

Contact information

Practice address
42 OLD NORTHPORT RD., KINGS PARK, NY 11754
(631) 366-0417
Mailing address
42 OLD NORTHPORT RD., KINGS PARK, NY 11754
(631) 366-0417

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
RO26799
NY
1041C0700X
Clinical Social Worker
Primary
R26799
NY

Other

Enumeration date
07/13/2006
Last updated
04/11/2014
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  • EDI platform