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General NPI Number Information
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NPI Number | 1235357237
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Entity Type | Organization
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Legal Business Name | THE FORTUNE SOCIETY INC.
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Dates
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Enumeration Date | 04/23/2007
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Last Update Date | 12/01/2025
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Provider Practice Location Address
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Address Line | THE FORTUNE SOCIETY INC. 29-76 NORTHERN BLVD 2ND FL
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City | LONG ISLAND CITY
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State | NY
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Zip | 11101-2822
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Country | US
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Telephone | 212-691-7554
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Fax | 347-510-3457
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Provider Business Mailing Address
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Address Line | 29-76 NORTHERN BLVD 2ND FL
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City | LONG ISLAND CITY
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State | NY
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Zip | 11101-2822
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Country | US
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Telephone | 347-510-3442
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Fax | 347-510-3457
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Authorized Official
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Title or Position | VP, AGENCY OPERATIONS
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Name | SHERRY GOLDSTEIN
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Credential |
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Telephone | 212-691-7554
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 17241
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 061211539
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 11776
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License Number State | NY
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Taxonomy #4
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 8095001A
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License Number State | NY
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Taxonomy #5
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 19241
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License Number State | NY
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Taxonomy #6
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 17947
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License Number State | NY
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Taxonomy #7
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 0483531
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License Number State | NY
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Taxonomy #8
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 141011539
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License Number State | NY
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