Healthcare Provider Details

I. General information

NPI: 1801365226
Provider Name (Legal Business Name): CYNTHIA OKOLSKI L.A.C.S.W.-R
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/14/2018
Last Update Date: 11/14/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

164 3RD AVE
BRENTWOOD NY
11717-5324
US

IV. Provider business mailing address

303 ARGYLE PL
BELLMORE NY
11710-3941
US

V. Phone/Fax

Practice location:
  • Phone: 631-273-2773
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberRO30434-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: