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General NPI Number Information
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NPI Number | 1629494273
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Entity Type | Organization
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Legal Business Name | NYC THERAPY GROUP, LCSWS PSYCHOTHERAPY PROFESSIONALS PLLC
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Dates
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Enumeration Date | 03/06/2014
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Last Update Date | 03/06/2014
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Provider Practice Location Address
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Address Line | 5731 MOSHOLU AVE 2ND FLOOR
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City | BRONX
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State | NY
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Zip | 10471-2205
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Country | US
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Telephone | 646-389-5801
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Fax |
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Provider Business Mailing Address
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Address Line | 5731 MOSHOLU AVE 2ND FLOOR
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City | BRONX
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State | NY
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Zip | 10471-2205
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Country | US
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Telephone | 646-389-5801
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. AMIR LEVINE
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Credential | PHD, LCSW, CASAC
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Telephone | 646-389-5801
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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 | 075669
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 074408
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License Number State | NY
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