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General NPI Number Information
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NPI Number | 1568883130
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Entity Type | Organization
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Legal Business Name | FACE TO FACE COUNSELING AND PSYCHOTHERAPY
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Dates
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Enumeration Date | 12/26/2013
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Last Update Date | 12/26/2013
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Provider Practice Location Address
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Address Line | 531 CENTRAL PARK AVE STE 104
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City | SCARSDALE
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State | NY
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Zip | 10583-1085
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Country | US
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Telephone | 917-834-6211
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Fax |
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Provider Business Mailing Address
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Address Line | 289 SOMMERVILLE PL
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City | YONKERS
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State | NY
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Zip | 10703-2212
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Country | US
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Telephone | 917-834-6211
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Fax | 914-206-3666
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Authorized Official
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Title or Position | PSYCHOTHERAPIST
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Name | MRS. CANDIDA ROSA DIAZ
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Credential | LCSW-R
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Telephone | 917-834-6211
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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 | R058985
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License Number State | NY
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