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General NPI Number Information
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NPI Number | 1053081042
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Entity Type | Organization
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Legal Business Name | THE COMMUNITY COUCH LCSW PLLC
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Dates
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Enumeration Date | 09/20/2021
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Last Update Date | 09/20/2021
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Provider Practice Location Address
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Address Line | 116 WEST 23RD STREET SUITE 500 - ROOM 33
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City | NEW YORK
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State | NY
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Zip | 10011
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Country | US
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Telephone | 347-244-5989
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Fax |
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Provider Business Mailing Address
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Address Line | 6801 SHORE RD APT 2C
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City | BROOKLYN
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State | NY
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Zip | 11220-5026
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Country | US
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Telephone | 347-517-5369
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Fax |
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Authorized Official
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Title or Position | OWNER/ORIGINAL MEMBER
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Name | MS. MELISSA FLANAGAN
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Credential | LCSW
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Telephone | 347-244-5989
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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 |
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License Number State |
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