Healthcare Provider Details
I. General information
NPI: 1972303782
Provider Name (Legal Business Name): TALK LCSW PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/19/2025
Last Update Date: 03/19/2025
Certification Date: 03/19/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
101 JACKIE CT
PATCHOGUE NY
11772-3395
US
IV. Provider business mailing address
101 JACKIE CT
PATCHOGUE NY
11772-3395
US
V. Phone/Fax
- Phone: 631-617-7532
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | |
| License Number State | |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
VIII. Authorized Official
Name:
AMANDA
PFLUMM
Title or Position: LCSW/CEO
Credential: LCSW
Phone: 631-617-7532