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General NPI Number Information
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NPI Number | 1053435107
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Entity Type | Individual
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Provider Name | COLLEEN MICHELLE GARVEY LCSW
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Gender | Female
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Dates
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Enumeration Date | 03/16/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 26 E PARK AVE SUITE 300
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City | LONG BEACH
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State | NY
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Zip | 11561-3595
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Country | US
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Telephone | 516-889-0080
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Fax | 516-785-4289
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Provider Business Mailing Address
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Address Line | 2775 ISLAND CHANNEL RD
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City | SEAFORD
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State | NY
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Zip | 11783-3324
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Country | US
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Telephone | 516-889-0080
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Fax | 516-785-4289
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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 | RO48618-1
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License Number State | NY
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