Organization
AMAVERA LCSW PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JILLIAN TUCKER DSW, LCSW (PRESIDENT)
(917) 279-3789
Entity
Organization
Contact information
Practice address
230 E 79TH ST APT 7A, NEW YORK, NY 10075-1213
(917) 279-3789
Mailing address
515 MADISON AVE, 9TH FLOOR #9062, NEW YORK, NY 10022
(917) 279-3789
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
07/16/2022
Last updated
07/16/2022
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