Healthcare Provider Details

I. General information

NPI: 1326304874
Provider Name (Legal Business Name): A COMPREHENSIVE COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/10/2012
Last Update Date: 04/10/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

98120 QUEENS BLVD
REGO PARK NY
11374-4357
US

IV. Provider business mailing address

98120 QUEENS BLVD
REGO PARK NY
11374-4357
US

V. Phone/Fax

Practice location:
  • Phone: 718-830-0246
  • Fax: 718-830-9088
Mailing address:
  • Phone: 718-830-0246
  • Fax: 718-830-9088

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name: MS. MARY BUTNER
Title or Position: MANAGER
Credential:
Phone: 718-830-0246