Healthcare Provider Details

I. General information

NPI: 1881910131
Provider Name (Legal Business Name): CATHOLIC CHARITIES NEIGBORHOOD SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/12/2010
Last Update Date: 04/12/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6729 MYRTLE AVE
GLENDALE NY
11385-7063
US

IV. Provider business mailing address

6729 MYRTLE AVE
GLENDALE NY
11385-7063
US

V. Phone/Fax

Practice location:
  • Phone: 718-456-7001
  • Fax:
Mailing address:
  • Phone: 718-456-7001
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: STEVEN KAMPTON
Title or Position: CLINICAL MANAGER
Credential: LCSW-R
Phone: 718-456-7001