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General NPI Number Information
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NPI Number | 1649983602
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Entity Type | Organization
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Legal Business Name | NURTURE YOUR NATURE PSYCHOTHERAPY LCSW PC
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Dates
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Enumeration Date | 01/04/2023
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Last Update Date | 10/15/2024
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Provider Practice Location Address
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Address Line | 2546 E 17TH ST STE 1
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City | BROOKLYN
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State | NY
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Zip | 11235-3561
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Country | US
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Telephone | 646-470-4174
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Fax |
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Provider Business Mailing Address
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Address Line | 345 OLD TOWN RD
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City | EAST SETAUKET
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State | NY
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Zip | 11733-3450
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Country | US
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Telephone | 347-884-5540
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MS. JACQUELINE M GERMAN
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Credential | LCSW
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Telephone | 347-884-5540
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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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