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General NPI Number Information
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NPI Number | 1619686599
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Entity Type | Organization
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Legal Business Name | IDLE THOUGHTS LLC
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Dates
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Enumeration Date | 11/18/2022
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Last Update Date | 11/18/2022
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Provider Practice Location Address
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Address Line | 1011 E 108TH ST APT 1C
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City | BROOKLYN
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State | NY
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Zip | 11236-3022
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Country | US
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Telephone | 718-974-3043
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Fax |
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Provider Business Mailing Address
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Address Line | 1011 E 108TH ST APT 1C
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City | BROOKLYN
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State | NY
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Zip | 11236-3022
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Country | US
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Telephone | 718-974-3043
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | DERRYCK NESBITT
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Credential |
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Telephone | 718-974-3043
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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