Organization
CLINICIANS OF THE DIASPORA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MONICA THOMPSON LCSW (C.E.O.)
(347) 509-4648
Entity
Organization
Contact information
Practice address
203 W 117TH ST APT 3E, NEW YORK, NY 10026-2139
(347) 509-4648
Mailing address
232 WEST 116TH STREET, P.O. BOX 1073, NEW YORK, NY 10026
(347) 509-4648
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
Other
Enumeration date
11/04/2020
Last updated
11/04/2020
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