Healthcare Provider Details

I. General information

NPI: 1710631460
Provider Name (Legal Business Name): UNION SQUARE COGNITIVE THERAPY/PSYCHOLOGY, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/10/2022
Last Update Date: 03/05/2022
Certification Date: 03/05/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

853 BROADWAY STE 2001
NEW YORK NY
10003-4705
US

IV. Provider business mailing address

853 BROADWAY STE 2001
NEW YORK NY
10003-4705
US

V. Phone/Fax

Practice location:
  • Phone: 917-854-7092
  • Fax:
Mailing address:
  • Phone: 917-854-7092
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: DR. RENE D ZWEIG
Title or Position: FOUNDER
Credential: PHD
Phone: 917-854-7092