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General NPI Number Information
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NPI Number | 1235840067
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Entity Type | Organization
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Legal Business Name | KATHY DOR PYSCHOTHERAPY, LCSW, PLLC
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Dates
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Enumeration Date | 12/13/2022
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Last Update Date | 12/13/2022
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Provider Practice Location Address
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Address Line | 197 SYLVESTER ST
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City | WESTBURY
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State | NY
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Zip | 11590-3907
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Country | US
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Telephone | 774-481-1590
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Fax |
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Provider Business Mailing Address
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Address Line | 1080 OLD COUNTRY RD # 1129
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City | WESTBURY
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State | NY
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Zip | 11590-5625
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Country | US
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Telephone | 774-481-1590
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | KATHY DOR
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Credential | LCSW-R
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Telephone | 516-710-1729
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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 |
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License Number State |
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