Organization
PORT COUNSELING CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AGNES LASETCHUK CSW (EXECUTIVE DIRECTOR)
(516) 767-1133
Entity
Organization
Contact information
Practice address
225 MAIN ST, PORT WASHINGTON, NY 11050-3211
(516) 767-1133
(516) 767-3680
Mailing address
225 MAIN ST, PORT WASHINGTON, NY 11050-3211
(516) 767-1133
(516) 767-3680
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02760429
—
NY
Enumeration date
10/11/2006
Last updated
08/22/2020
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