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Organization
LONG ISLAND CITY PSYCHOTHERAPY SERVICES LCSW, PC
Active
Organization
LONG ISLAND CITY PSYCHOTHERAPY SERVICES LCSW, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MURIEL DETHOMAS LCSW (PRESIDENT)
(718) 721-0606
Entity
Organization
Contact information
Practice address
301 27TH AVE, LONG ISLAND CITY, NY 11102-4616
(718) 721-0606
(718) 204-5481
Mailing address
301 27TH AVE, LONG ISLAND CITY, NY 11102-4616
(718) 721-0606
(718) 204-5481
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
R006721
NY
Other
Enumeration date
04/25/2012
Last updated
04/25/2012
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