Healthcare Provider Details

I. General information

NPI: 1346032455
Provider Name (Legal Business Name): LOWER WEST SIDE HOUSEHOLD SERVICES CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2025
Last Update Date: 12/01/2025
Certification Date: 12/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 SOUTH BROADWAY 4TH FLOOR, SUITE 464
WHITE PLAINS NY
10601
US

IV. Provider business mailing address

75 S BROADWAY
WHITE PLAINS NY
10601-4413
US

V. Phone/Fax

Practice location:
  • Phone: 914-722-2467
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: LUCIA PONS
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 212-307-7107