Organization
BLUE HAVEN CONFIDENTIAL COUNSELING AND PSYCHOTHERAPY SERVICES LCSW P.C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DOROTHY FRAZIER LCSW-R (DIRECTOR)
(718) 415-3832
Entity
Organization
Contact information
Practice address
6143 186TH ST, FRESH MEADOWS, NY 11365-2710
(347) 506-3986
(718) 475-2122
Mailing address
20417 HILLSIDE AVE, SUITE 309, HOLLIS, NY 11423-2213
(347) 506-3968
(718) 475-2122
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
R0383781
NY
Other
Enumeration date
05/01/2013
Last updated
05/01/2013
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