=====================================================
General NPI Number Information
=====================================================
NPI Number | 1346104692
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ANEW LICENSED CLINICAL SOCIAL WORK SERVICES PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/11/2025
-----------------------------------------------------
Last Update Date | 12/11/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 298 WASHINGTON PL
-----------------------------------------------------
City | LAWRENCE
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11559-1235
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 516-405-5477
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 241 UNION ST
-----------------------------------------------------
City | LAWRENCE
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11559-1220
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 516-405-5477
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | MR. SHRAGA CHAFETZ
-----------------------------------------------------
Credential | LCSW
-----------------------------------------------------
Telephone | 516-405-5477
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------