1710694930 NPI number — YELLOW BIRD PSYCHOTHERAPY LCSW PC Ekaterina Mozer LCSW, CASAC

Table of content: Ekaterina Mozer LCSW, CASAC (NPI 1710694930)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1710694930 NPI number — YELLOW BIRD PSYCHOTHERAPY LCSW PC Ekaterina Mozer LCSW, CASAC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
YELLOW BIRD PSYCHOTHERAPY LCSW PC
Provider Last Name:
Mozer
Provider First Name:
Ekaterina
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LCSW, CASAC
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:
1710694930
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/28/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
35 Seacoast Terrace
Provider Second Line Business Mailing Address:
7G
Provider Business Mailing Address City Name:
Brooklyn NY
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11235
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
6467613743
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
35 Seacoast Terrace
Provider Second Line Business Practice Location Address:
7G
Provider Business Practice Location Address City Name:
Brooklyn NY
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11235
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
6467613743
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/28/2022

Additional Information

Authorized Official

Authorized Official Last Name:
MOZER
Authorized Official First Name:
EKATERINA
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
646-761-3743

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  086079-01 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2025 www.npivalidator.com