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General NPI Number Information
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NPI Number | 1376957654
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Entity Type | Organization
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Legal Business Name | WORK IN PROGRESS THERAPEUTIC SERVICES LCSW P.L.L.C
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Dates
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Enumeration Date | 06/16/2014
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Last Update Date | 08/22/2015
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Provider Practice Location Address
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Address Line | 1259 WANTAGH AVE
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City | WANTAGH
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State | NY
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Zip | 11793-2205
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Country | US
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Telephone | 516-710-0235
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Fax |
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Provider Business Mailing Address
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Address Line | 207 FREDERICK AVE
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City | ROOSEVELT
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State | NY
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Zip | 11575-2333
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Country | US
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Telephone | 516-710-0235
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CHERYLANN MCCALLA
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Credential | LCSW
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Telephone | 516-710-0235
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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 | 081627
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License Number State | NY
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