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General NPI Number Information
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NPI Number | 1487434163
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Entity Type | Organization
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Legal Business Name | POWHERFUL AND BRILLIANT BEYOND MEASURE LLC
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Dates
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Enumeration Date | 10/02/2023
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Last Update Date | 10/02/2023
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Provider Practice Location Address
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Address Line | 3425 KNOX PLACE STE 1K
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City | BRONX
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State | NY
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Zip | 10467
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Country | US
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Telephone | 929-563-8800
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Fax |
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Provider Business Mailing Address
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Address Line | 3425 KNOX PLACE STE 1K
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City | BRONX
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State | NY
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Zip | 10467
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Country | US
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Telephone | 929-563-8800
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Fax |
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Authorized Official
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Title or Position | CLINICAL SOCIAL WORKER
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Name | DR. ERICA M PONTEEN, PHD, LCSW
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Credential | PHD, LCSW
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Telephone | 929-563-8800
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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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Taxonomy #2
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Taxonomy Code | 1744R1102X
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Taxonomy Name | Research Study Specialist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 171000000X
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Taxonomy Name | Military Health Care Provider
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License Number |
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License Number State |
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