Individual
BRANDON TOSOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
24 BELLEMEADE AVE STE 24-102, SMITHTOWN, NY 11787-1855
(631) 317-4079
Mailing address
865 BROADWAY AVE APT 201B, HOLBROOK, NY 11741-4946
(631) 317-4079
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
104100000X
Social Worker
099048-1
NY
1041C0700X
Clinical Social Worker
Primary
090959
NY
Other
Enumeration date
09/10/2015
Last updated
06/23/2022
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