Healthcare Provider Details

I. General information

NPI: 1811613086
Provider Name (Legal Business Name): WESTCHESTER LCSW THERAPY, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/18/2022
Last Update Date: 10/18/2022
Certification Date: 10/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 MAMARONECK AVE STE 400
HARRISON NY
10528-1613
US

IV. Provider business mailing address

3003 PURCHASE ST UNIT 358
PURCHASE NY
10577-7530
US

V. Phone/Fax

Practice location:
  • Phone: 914-708-7613
  • Fax:
Mailing address:
  • Phone: 914-708-7613
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: MR. DANIEL JOSEPH BROOKS
Title or Position: MANAGING MEMBER
Credential: LCSW
Phone: 914-708-7613