Healthcare Provider Details

I. General information

NPI: 1194716092
Provider Name (Legal Business Name): JUNE DOYLE LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/31/2005
Last Update Date: 06/17/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

510 HEMPSTEAD TPKE STE # 202
WEST HEMPSTEAD NY
11552-1147
US

IV. Provider business mailing address

510 HEMPSTEAD TPKE STE. #202
WEST HEMPSTEAD NY
11552-1147
US

V. Phone/Fax

Practice location:
  • Phone: 516-546-1370
  • Fax: 516-546-1028
Mailing address:
  • Phone: 516-437-6050
  • Fax: 516-437-6304

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number078581
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: