=====================================================
General NPI Number Information
=====================================================
NPI Number | 1396201091
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | THERAPY IN NYC LCSW PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/18/2019
-----------------------------------------------------
Last Update Date | 02/18/2019
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 7 WEST 30TH STREET 11TH FLOOR, SUITE # 13
-----------------------------------------------------
City | NEW YORK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10001
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 914-325-3637
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 7 WEST 30TH STREET 11TH FLOOR, SUITE # 13
-----------------------------------------------------
City | NEW YORK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10001
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 914-325-3637
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | FOUNDER & CLINICAL DIRECTOR
-----------------------------------------------------
Name | MRS. ILENA OSMA
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 914-325-3637
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------