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Organization

LONG ISLAND CITY PSYCHOTHERAPY SERVICES LCSW, PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. MURIEL DETHOMAS LCSW (PRESIDENT)
(718) 721-0606
Entity
Organization

Contact information

Practice address
301 27TH AVE, LONG ISLAND CITY, NY 11102-4616
(718) 721-0606
(718) 204-5481
Mailing address
301 27TH AVE, LONG ISLAND CITY, NY 11102-4616
(718) 721-0606
(718) 204-5481

Taxonomy

Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
R006721
NY

Other

Enumeration date
04/25/2012
Last updated
04/25/2012
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