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Organization
CRESCENT LIGHT COUNSELING, LCSW, PLLC
Active
Organization
CRESCENT LIGHT COUNSELING, LCSW, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TAYLOR SCHULTZ LCSW (MANAGER/OWNER)
(631) 617-3696
Entity
Organization
Contact information
Practice address
646 MAIN ST STE 102, PORT JEFFERSON, NY 11777-2230
(631) 772-9395
Mailing address
646 MAIN ST STE 102, PORT JEFFERSON, NY 11777-2230
(631) 772-9395
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
03/06/2022
Last updated
03/28/2022
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