Healthcare Provider Details

I. General information

NPI: 1083011498
Provider Name (Legal Business Name): NELSON FELIX ESPINAL LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/01/2014
Last Update Date: 12/01/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

116E 28 ST.
BROOKLYN NY
11226
US

IV. Provider business mailing address

116E 28 ST.
BROOKLYN NY
11226
US

V. Phone/Fax

Practice location:
  • Phone: 347-237-8801
  • Fax:
Mailing address:
  • Phone: 347-237-8801
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number072765
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number610511
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: