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General NPI Number Information
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NPI Number | 1245950492
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Entity Type | Organization
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Legal Business Name | ELPIDA PSYCHOTHERAPY LCSW PLLC
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Dates
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Enumeration Date | 08/29/2022
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Last Update Date | 04/19/2023
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Provider Practice Location Address
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Address Line | 265 SUNRISE HWY STE 1-134
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City | ROCKVILLE CENTRE
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State | NY
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Zip | 11570-4912
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Country | US
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Telephone | 646-535-2099
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Fax |
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Provider Business Mailing Address
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Address Line | 265 SUNRISE HWY STE 1-134
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City | ROCKVILLE CENTRE
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State | NY
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Zip | 11570-4912
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Country | US
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Telephone | 646-535-2099
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Fax |
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Authorized Official
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Title or Position | EMPLOYEE -SOLE MEMBER PLLC
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Name | MS. CONSTANTINA BUCHALA
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Credential | LCSW
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Telephone | 646-535-2099
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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