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General NPI Number Information
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NPI Number | 1477351773
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Entity Type | Organization
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Legal Business Name | MOMENTUM COUNSELING SERVICES LCSW, PLLC
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Dates
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Enumeration Date | 03/04/2025
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Last Update Date | 03/13/2025
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Provider Practice Location Address
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Address Line | 25 MELVILLE PARK RD STE 110B
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City | MELVILLE
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State | NY
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Zip | 11747-3182
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Country | US
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Telephone | 631-371-4305
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Fax |
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Provider Business Mailing Address
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Address Line | 203 SMITH AVE
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City | HOLBROOK
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State | NY
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Zip | 11741-1150
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Country | US
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Telephone | 631-371-4305
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. THOMAS MICHAEL PICA
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Credential | MSW, LCSW, CASAC-2
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Telephone | 631-923-7431
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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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