Organization
LISTENING CAREFULLY INDIVIDUAL & FAMILY COUNSELING SERVICES
Active
Organization
LISTENING CAREFULLY INDIVIDUAL & FAMILY COUNSELING SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ESTELLE A BROUSSEAU LCSW-R (LICENSE CLINICAL SOCIAL WORKER)
(718) 356-0430
Entity
Organization
Contact information
Practice address
77 OCEANIC AVE, STATEN ISLAND, NY 10312-6513
(718) 356-0430
Mailing address
77 OCEANIC AVENUE, STATEN ISLAND, NY 10312-6509
(718) 356-0430
(718) 605-7075
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
NYSR054862
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1902951072
PROVIDER NPI
NY
Enumeration date
03/07/2012
Last updated
03/07/2012
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