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General NPI Number Information
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NPI Number | 1144699315
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Entity Type | Organization
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Legal Business Name | A.V.S.P. CONSULTANT & COUNSELING INC
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Dates
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Enumeration Date | 09/17/2015
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Last Update Date | 09/17/2015
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Provider Practice Location Address
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Address Line | 845 3RD AVE FL 6
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City | NEW YORK
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State | NY
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Zip | 10022-6630
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Country | US
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Telephone | 718-752-3652
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Fax | 212-369-6276
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Provider Business Mailing Address
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Address Line | 56 CRESCENT AVE 3
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City | STATEN ISLAND
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State | NY
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Zip | 10301-1752
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Country | US
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Telephone | 718-753-3652
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Fax | 212-369-6276
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Authorized Official
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Title or Position | PRESIDENT
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Name | GLORIA BROWN
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Credential | L.C.S.W.-R
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Telephone | 718-752-3652
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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 | R029782
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License Number State | NY
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