Organization
MENTAL HEALTH PROVIDERS OF WESTERN QUEENS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHERINE LAING AMBIA LMSW (CLINICIAN)
(917) 566-3754
Entity
Organization
Contact information
Practice address
3708 91ST ST, SUITE 3A, JACKSON HEIGHTS, NY 11372-7928
(718) 779-2263
(718) 779-2225
Mailing address
213 TAAFFE PL, APT. 214, BROOKLYN, NY 11205-4378
(917) 566-3754
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
094706
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
094706
LMSW LICENSE NUMBER
NY
Enumeration date
07/17/2015
Last updated
07/17/2015
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