# PLAYDATE LMSW SOCIAL WORK PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1780838060
- **Authorized official:** MS. OLIVIA J NELSON LMSW (SOLE MBR)
- **Authorized official phone:** (917) 863-3780

## Contact information

- **Practice address:** 208 W 119TH ST, SUITE 3R, NEW YORK, NY 10026-1209
- **Practice address phone:** (917) 863-3780
- **Practice address fax:** (646) 596-7791
- **Mailing address:** 208 W 119TH ST, SUITE 3R, NEW YORK, NY 10026-1209
- **Mailing address phone:** (917) 863-3780
- **Mailing address fax:** (646) 596-7791

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM0855X | Adolescent and Children Mental Health Clinic/Center | 061668-1 | NY | Yes |

## Other

- **Enumeration date:** 11/12/2008
- **Last updated:** 11/12/2008