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General NPI Number Information
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NPI Number | 1326634122
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Entity Type | Organization
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Legal Business Name | LONG ISLAND NEW HOPE COUNSELING SERVICES, LCSW, PLLC
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Dates
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Enumeration Date | 12/15/2020
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Last Update Date | 12/15/2020
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Provider Practice Location Address
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Address Line | 551 N COUNTRY RD STE 203
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City | SAINT JAMES
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State | NY
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Zip | 11780-1445
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Country | US
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Telephone | 631-974-5052
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 420
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City | SOUND BEACH
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State | NY
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Zip | 11789-0420
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Country | US
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Telephone | 631-974-5052
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DANIEL R GIRARD-DOMENA
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Credential | LCSW
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Telephone | 631-974-5052
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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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