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Organization
LONG ISLAND PSYCHOTHERAPY & COUNSELING, LCSW P.C.
Active
Organization
LONG ISLAND PSYCHOTHERAPY & COUNSELING, LCSW P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PABLO IDEZ (PRESIDENT)
(347) 772-8373
Entity
Organization
Contact information
Practice address
97 POWERHOUSE RD STE 104, ROSLYN HEIGHTS, NY 11577-2046
(347) 772-8373
Mailing address
8 DALTON LN, EAST NORTHPORT, NY 11731-3909
(347) 772-8373
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
063837
NY
Other
Enumeration date
03/16/2017
Last updated
12/13/2020
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