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General NPI Number Information
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NPI Number | 1285090845
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Entity Type | Organization
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Legal Business Name | LIVING POSITIVE INC
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Dates
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Enumeration Date | 01/12/2016
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Last Update Date | 01/12/2016
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Provider Practice Location Address
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Address Line | 250 FULTON AVE SUITE 418
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City | HEMPSTEAD
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State | NY
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Zip | 11550-3917
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Country | US
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Telephone | 718-916-3359
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Fax | 646-374-3955
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Provider Business Mailing Address
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Address Line | 11305 202ND ST
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City | SAINT ALBANS
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State | NY
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Zip | 11412-2530
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Country | US
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Telephone | 718-264-7803
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Fax | 646-374-3955
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Authorized Official
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Title or Position | PRESIDENT
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Name | CELINE BOBB-INNISS
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Credential | LCSW-R
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Telephone | 718-916-3359
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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 | R047220-1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | R047220-1
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | R047220-1
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License Number State | NY
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Taxonomy #4
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | R047220-1
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License Number State | NY
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