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NPI 1477267938

NPI 1477267938 : DELIBERATE PSYCHOTHERAPY COLLABORATIVE LCSW : NEW YORK, NY

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General NPI Number Information
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    NPI Number           |    1477267938
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    Entity Type          |    Organization 
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    Legal Business Name  |    DELIBERATE PSYCHOTHERAPY COLLABORATIVE LCSW 
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Dates
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    Enumeration Date     |    01/10/2023
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    Last Update Date     |    01/10/2023
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Provider Practice Location Address
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    Address Line         |    336 CENTRAL PARK W APT 11E 
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    City                 |    NEW YORK
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    State                |    NY
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    Zip                  |    10025-7124
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    Country              |    US
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    Telephone            |    212-749-3768
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    336 CENTRAL PARK W APT 11E 
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    City                 |    NEW YORK
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    State                |    NY
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    Zip                  |    10025-7124
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    Country              |    US
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    Telephone            |    212-749-3768
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    Fax                  |    
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Authorized Official
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    Title or Position    |    SOCIAL WORKER
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    Name                 |    MS. LAUREN  SHAH 
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    Credential           |    LCSW-R
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    Telephone            |    212-749-3768
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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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