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NPI Code Detail

MEDICARE: INTERCITY PSYCHOTHERAPY SERVICES LCSW, P.C.

MEDICARE: INTERCITY PSYCHOTHERAPY SERVICES LCSW, P.C.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084P0800XPsychiatry Physician
2363LP0808XPsychiatric/Mental Health Nurse Practitioner
3106H00000XMarriage & Family Therapist
4171M00000XCase Manager/Care Coordinator
5101YM0800XMental Health Counselor
61041C0700XClinical Social Worker

General Provider Information

NPI Number : 1437733961
Entity Type Code : Organization
Provider Name (Legal Business Name) : INTERCITY PSYCHOTHERAPY SERVICES LCSW, P.C.
Provider Business Mailing Address
First Line : 7906 4TH AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11209-3907
Country : US
Telephone Number : 646-287-5199
Fax Number :
Provider Business Practice Location Address
First Line : 7906 4TH AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11209-3907
Country : US
Telephone Number : 718-704-0898
Fax Number :
Authorized Official
Title or Position : OWNER
Name : MILLICENT AMPADU
Credential : LCSW
Telephone Number : 646-287-5199
Provider Enumeration Date : 05/11/2021
Last Update Date : 03/29/2025

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