Healthcare Provider Details

I. General information

NPI: 1932677168
Provider Name (Legal Business Name): SENIOR CARE THERAPY LCSW OF NEW YORK PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/06/2018
Last Update Date: 02/21/2024
Certification Date: 02/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14415 68TH RD
FLUSHING NY
11367-1330
US

IV. Provider business mailing address

2719 HOLLYWOOD BLVD STE 5469
HOLLYWOOD FL
33020-4821
US

V. Phone/Fax

Practice location:
  • Phone: 973-264-0023
  • Fax: 973-264-0022
Mailing address:
  • Phone: 973-264-0023
  • Fax: 973-264-0022

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: ALISA YVONNE ROSENFELD
Title or Position: OWNER
Credential: LCSW
Phone: 973-264-0023