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General NPI Number Information
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NPI Number | 1013433325
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Entity Type | Individual
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Provider Name | COLIN SCOTT LENTZ LCSW
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Gender | Male
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Dates
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Enumeration Date | 08/17/2017
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Last Update Date | 09/23/2020
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Provider Practice Location Address
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Address Line | 850 7TH AVE STE 706
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City | NEW YORK
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State | NY
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Zip | 10019-5438
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Country | US
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Telephone | 347-987-1472
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Fax |
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Provider Business Mailing Address
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Address Line | 3424 82ND ST APT 4D
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City | JACKSON HEIGHTS
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State | NY
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Zip | 11372-2912
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Country | US
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Telephone | 508-332-0431
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 090110-01
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 100809-1
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License Number State | NY
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