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General NPI Number Information
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NPI Number | 1063886471
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Entity Type | Organization
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Legal Business Name | MOREAU LMSW CHILDREN AND FAMILY SERVICES P.C
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Dates
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Enumeration Date | 11/23/2015
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Last Update Date | 11/23/2015
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Provider Practice Location Address
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Address Line | 764 SAINT NICHOLAS AVE
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City | NEW YORK
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State | NY
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Zip | 10031-4043
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Country | US
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Telephone | 212-234-1036
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Fax | 212-234-1036
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Provider Business Mailing Address
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Address Line | 764 SAINT NICHOLAS AVE
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City | NEW YORK
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State | NY
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Zip | 10031-4043
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Country | US
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Telephone | 212-234-1036
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Fax | 212-234-1036
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Authorized Official
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Title or Position | CEO
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Name | MRS. YOLANDE MOREAU
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Credential | LMSW
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Telephone | 212-234-1036
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number | DC2550
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License Number State | NY
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