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General NPI Number Information
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NPI Number | 1073636619
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Entity Type | Organization
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Legal Business Name | OLIVIA PINSLEY
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Dates
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Enumeration Date | 04/09/2007
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Last Update Date | 03/04/2014
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Provider Practice Location Address
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Address Line | 445 NORTHERN BLVD SUITE 12
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City | GREAT NECK
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State | NY
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Zip | 11021-4804
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Country | US
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Telephone | 516-642-1174
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Fax | 516-467-4267
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Provider Business Mailing Address
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Address Line | 445 NORTHERN BLVD SUITE 12
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City | GREAT NECK
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State | NY
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Zip | 11021-4804
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Country | US
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Telephone | 516-642-1174
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Fax | 516-467-4267
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Authorized Official
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Title or Position | PSYCHOTHERAPIST
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Name | OLIVIA PINSLEY
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Credential | PH.D., LCSW-R
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Telephone | 516-642-1174
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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 | R041584-1
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License Number State | NY
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