Organization
EARLY INTERVENTION LCSW SERVICES PC
Active
Organization
EARLY INTERVENTION LCSW SERVICES PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DEBORAH LYNNE HARADON LCSW (PRESIDENT)
(845) 485-7237
Entity
Organization
Contact information
Practice address
220 ROGERS ST, ULSTER PARK, NY 12487-5015
(845) 485-7237
Mailing address
220 ROGERS ST, ULSTER PARK, NY 12487-5015
(845) 339-2462
(845) 339-2462
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
04126401
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03552105
—
NY
Enumeration date
01/29/2018
Last updated
01/29/2018
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