Healthcare Provider Details

I. General information

NPI: 1083294334
Provider Name (Legal Business Name): TINTER LCSW PSYCHOTHERAPY PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/12/2021
Last Update Date: 04/12/2021
Certification Date: 04/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1068 MAIN ST STE 201
FISHKILL NY
12524-3659
US

IV. Provider business mailing address

11 TAMARACK DR
HOPEWELL JUNCTION NY
12533-6432
US

V. Phone/Fax

Practice location:
  • Phone: 845-270-0974
  • Fax:
Mailing address:
  • Phone: 845-270-0974
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: SAMANTHA TINTER
Title or Position: OWNER
Credential: LCSW
Phone: 845-270-0974