Healthcare Provider Details

I. General information

NPI: 1952997397
Provider Name (Legal Business Name): COMMUNTIES CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/20/2020
Last Update Date: 12/20/2020
Certification Date: 12/20/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3068 38TH ST APT 2B
ASTORIA NY
11103-5096
US

IV. Provider business mailing address

3068 38TH ST APT 2B
ASTORIA NY
11103-5096
US

V. Phone/Fax

Practice location:
  • Phone: 347-906-1001
  • Fax:
Mailing address:
  • Phone: 347-906-1001
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: INGRID MCFARLANE
Title or Position: PARTNER
Credential: LCSW-R
Phone: 347-906-1001