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Organization
FACES NY, INC.
Active
Organization
FACES NY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KEITH DOUGLAS BLACKBURN LCSW (CLINICAL SUPERVISOR)
(212) 865-0960
Entity
Organization
Contact information
Practice address
114 W 116TH ST, NEW YORK, NY 10026-2679
(212) 865-0960
(212) 663-4310
Mailing address
114 W 116TH ST, NEW YORK, NY 10026-2679
(212) 865-0960
(212) 663-4310
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
085451
NY
Other
Enumeration date
08/01/2017
Last updated
08/01/2017
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