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General NPI Number Information
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NPI Number | 1285442517
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Entity Type | Organization
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Legal Business Name | INSIDE OUT PSYCHOTHERAPY LCSW PLLC
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Dates
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Enumeration Date | 12/19/2024
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Last Update Date | 12/19/2024
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Provider Practice Location Address
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Address Line | 1802 AVENUE K
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City | BROOKLYN
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State | NY
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Zip | 11230-4457
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Country | US
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Telephone | 718-614-5449
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Fax |
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Provider Business Mailing Address
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Address Line | 1802 AVENUE K
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City | BROOKLYN
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State | NY
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Zip | 11230-4457
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Country | US
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Telephone | 718-614-5449
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | RON WITONSKY
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Credential | LCSW
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Telephone | 718-614-5449
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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