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Organization
OMNI PSYCHOTHERAPY, LCSW, P.C.
Active
Organization
OMNI PSYCHOTHERAPY, LCSW, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IVAN DILLER LCSW-R (PRESIDENT)
(917) 805-0044
Entity
Organization
Contact information
Practice address
180 S BROADWAY STE 405, WHITE PLAINS, NY 10605-1820
(917) 805-0044
(718) 684-4896
Mailing address
180 S BROADWAY STE 405, WHITE PLAINS, NY 10605-1820
(917) 805-0044
(718) 684-4896
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
R978093
NY
Other
Enumeration date
08/10/2018
Last updated
07/11/2019
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