Healthcare Provider Details

I. General information

NPI: 1124377288
Provider Name (Legal Business Name): MICHAEL GARBE LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/05/2012
Last Update Date: 06/04/2020
Certification Date: 06/04/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3046 NORTHERN BLVD
LONG ISLAND CITY NY
11101-2816
US

IV. Provider business mailing address

6268 ELLWELL CRES
REGO PARK NY
11374-4838
US

V. Phone/Fax

Practice location:
  • Phone: 718-424-6191
  • Fax:
Mailing address:
  • Phone: 646-373-1911
  • 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:
Title or Position:
Credential:
Phone: