Healthcare Provider Details

I. General information

NPI: 1154653616
Provider Name (Legal Business Name): PEOPLE TALK, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/09/2010
Last Update Date: 02/09/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 MAIN ST SUITE D
PORT JEFFERSON NY
11777-2250
US

IV. Provider business mailing address

1000 MAIN ST SUITE D
PORT JEFFERSON NY
11777-2250
US

V. Phone/Fax

Practice location:
  • Phone: 631-921-9138
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number072250
License Number StateNY

VIII. Authorized Official

Name: WILLIAM O'LEARY
Title or Position: PRESIDENT
Credential: LCSW-R
Phone: 631-921-9138