MEDICARE: COMPREHENSIVE COUNSELING LCSW, PLLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	101YM0800X	Mental Health Counselor
2	106H00000X	Marriage & Family Therapist
3	1041C0700X	Clinical Social Worker

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1982798773
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMPREHENSIVE COUNSELING LCSW, PLLC

Provider Business Mailing Address
First Line	:	3635 BELL BLVD STE 203
Second Line	:
City	:	BAYSIDE
State	:	NY
Zip	:	11361-2097
Country	:	US
Telephone Number	:	718-830-0246
Fax Number	:	718-830-9088

Provider Business Practice Location Address
First Line	:	3635 BELL BLVD STE 203
Second Line	:
City	:	BAYSIDE
State	:	NY
Zip	:	11361-2097
Country	:	US
Telephone Number	:	718-830-0246
Fax Number	:	718-830-9088

Authorized Official
Title or Position	:	CEO
Name	:	KATHLEEN EGGER
Credential	:	ED.D.
Telephone Number	:	508-732-9101

Provider Enumeration Date	:	10/03/2006
Last Update Date	:	09/11/2024

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