Healthcare Provider Details
I. General information
NPI: 1649459439
Provider Name (Legal Business Name): LOUIS ENRIQUE FLORES LMSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 10/29/2007
Last Update Date: 01/17/2012
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
175 FULTON AVE STE 300
HEMPSTEAD NY
11550-3702
US
IV. Provider business mailing address
1146 ARLINGTON AVE
FRANKLIN SQUARE NY
11010-1336
US
V. Phone/Fax
- Phone: 516-481-0052
- Fax: 516-481-2115
- Phone: 516-225-9063
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YA0400X |
| Taxonomy | Addiction (Substance Use Disorder) Counselor |
| License Number | 7495 |
| License Number State | NY |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | 066753 |
| License Number State | NY |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: