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Organization
LONG ISLAND CONSULTATION CENTER, INC.
Active
Organization
LONG ISLAND CONSULTATION CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ELAINE LEDERER LCSW (EXECUTIVE DIRECTOR)
(718) 896-3400
Entity
Organization
Contact information
Practice address
9131 QUEENS BLVD STE 222, ELMHURST, NY 11373-5511
(718) 896-3400
(718) 459-5621
Mailing address
9131 QUEENS BLVD STE 222, ELMHURST, NY 11373-5511
(718) 896-3400
(718) 459-5621
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
090210852
NY
1041C0700X
Clinical Social Worker
Primary
6715100A
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00244019
—
NY
Enumeration date
02/15/2007
Last updated
11/02/2016
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