Organization
CHRIST BASED THERAPY LCSW P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANITA ESTHER LA ROSA LCSW-R (CLINICAL DIRECTOR)
(917) 562-7354
Entity
Organization
Contact information
Practice address
18240 HILLSIDE AVE, 1ST FLOOR, JAMAICA, NY 11432-4837
(917) 562-7354
Mailing address
18240 HILLSIDE AVE, 1ST FLOOR, JAMAICA, NY 11432-4837
(917) 562-7354
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
R075177-1
NY
Other
Enumeration date
10/18/2012
Last updated
04/11/2013
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