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General NPI Number Information
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NPI Number | 1548868607
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Entity Type | Organization
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Legal Business Name | PRESCOTT PSYCHOTHERAPY WELLNESS LCSW PLLC
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Dates
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Enumeration Date | 10/12/2020
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Last Update Date | 10/12/2020
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Provider Practice Location Address
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Address Line | 285 LEXINGTON AVE FL 2A
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City | NEW YORK
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State | NY
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Zip | 10016-3592
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Country | US
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Telephone | 201-464-2057
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Fax |
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Provider Business Mailing Address
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Address Line | 200 E 33RD ST APT 32D
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City | NEW YORK
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State | NY
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Zip | 10016-4832
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Country | US
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Telephone | 973-943-2618
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Fax |
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Authorized Official
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Title or Position | LCSW
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Name | MEREDITH PRESCOTT
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Credential |
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Telephone | 973-943-2618
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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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