1477728954 NPI number — LCG COUNSELING SERVICES, LCSW, P.C.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1477728954 NPI number — LCG COUNSELING SERVICES, LCSW, P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LCG COUNSELING SERVICES, LCSW, P.C.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1477728954
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/23/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
15 CUTTERMILL ROAD
Provider Second Line Business Mailing Address:
SUITE 102
Provider Business Mailing Address City Name:
GREAT NECK
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11021
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
917-805-7934
Provider Business Mailing Address Fax Number:
718-639-1564

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4322 50TH ST
Provider Second Line Business Practice Location Address:
SUITE #2C
Provider Business Practice Location Address City Name:
WOODSIDE
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11377-4442
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
917-805-7934
Provider Business Practice Location Address Fax Number:
718-639-1564
Provider Enumeration Date:
04/25/2008

Additional Information

Authorized Official

Authorized Official Last Name:
GLOSSZA
Authorized Official First Name:
LISA
Authorized Official Middle Name:
C
Authorized Official Title or Position:
CLINICAL SOCIAL WORKER
Authorized Official Telephone Number:
917-805-7934

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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