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General NPI Number Information
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NPI Number | 1417147133
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Entity Type | Organization
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Legal Business Name | FAMILY MATTERS SERVICES LCSW, PLLC
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Dates
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Enumeration Date | 07/30/2007
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Last Update Date | 07/30/2007
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Provider Practice Location Address
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Address Line | 250 5TH AVE SUITE 310
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City | NEW YORK
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State | NY
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Zip | 10001-6405
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Country | US
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Telephone | 212-537-6419
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Fax | 212-532-5125
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Provider Business Mailing Address
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Address Line | 250 5TH AVE SUITE 310
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City | NEW YORK
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State | NY
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Zip | 10001-6405
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Country | US
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Telephone | 212-537-6419
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Fax | 212-532-5125
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MS. ANN N. SYDOR
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Credential | LCSW
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Telephone | 212-537-6419
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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 | 075345
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License Number State | NY
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