Healthcare Provider Details

I. General information

NPI: 1033634050
Provider Name (Legal Business Name): SYBIL NURSE-REEVES LCSW COUNSELING SERVICES, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2017
Last Update Date: 03/19/2024
Certification Date: 03/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13130 MERRICK BLVD
JAMAICA NY
11434-4134
US

IV. Provider business mailing address

13130 MERRICK BLVD
JAMAICA NY
11434-4134
US

V. Phone/Fax

Practice location:
  • Phone: 718-233-2556
  • Fax: 718-233-2569
Mailing address:
  • Phone: 718-233-2556
  • Fax: 718-233-2569

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberR045601-1
License Number StateNY

VIII. Authorized Official

Name: MRS. SYBIL NURSE-REEVES
Title or Position: OWNER
Credential: LCSW
Phone: 718-233-2556