Healthcare Provider Details

I. General information

NPI: 1013625961
Provider Name (Legal Business Name): PHRONETIC PSYCHOTHERAPY LCSW PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/09/2022
Last Update Date: 06/16/2025
Certification Date: 06/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16 MADISON SQ W
NEW YORK NY
10010-1627
US

IV. Provider business mailing address

16 MADISON SQ W
NEW YORK NY
10010-1627
US

V. Phone/Fax

Practice location:
  • Phone: 646-866-0605
  • Fax:
Mailing address:
  • Phone: 646-866-0605
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: CLARICE HASSAN
Title or Position: PRESIDENT AND CEO
Credential: LCSW
Phone: 646-866-0605