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General NPI Number Information
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NPI Number | 1245738343
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Entity Type | Organization
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Legal Business Name | UNITED COUNSELING ASSOCIATES LCSW LLC
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Dates
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Enumeration Date | 01/24/2018
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Last Update Date | 01/24/2018
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Provider Practice Location Address
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Address Line | 107 FLEET CT
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City | BRONX
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State | NY
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Zip | 10473-2454
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Country | US
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Telephone | 917-817-4422
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Fax |
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Provider Business Mailing Address
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Address Line | 107 FLEET CT
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City | BRONX
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State | NY
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Zip | 10473-2454
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Country | US
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Telephone | 917-817-4422
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. DUJARDIN BONET
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Credential | LCSW-R, MSW
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Telephone | 917-817-4422
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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 | 060613
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License Number State | NY
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