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General NPI Number Information
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NPI Number | 1669859583
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Entity Type | Organization
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Legal Business Name | NOS CONSULTING LICENSED CLINICAL SOCIAL WORKER, PLLC
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Dates
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Enumeration Date | 04/29/2015
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Last Update Date | 04/29/2015
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Provider Practice Location Address
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Address Line | 19 W 34TH ST PH-FLOOR
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City | NEW YORK
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State | NY
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Zip | 10001-3006
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Country | US
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Telephone | 917-597-3651
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Fax | 212-426-2447
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Provider Business Mailing Address
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Address Line | 19 W 34TH ST PH-FLOOR
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City | NEW YORK
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State | NY
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Zip | 10001-3006
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Country | US
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Telephone | 917-597-3651
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Fax | 212-426-2447
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Authorized Official
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Title or Position | FOUNDER & CEO
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Name | MR. JAMES ANTONIO VAUGHAN
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Credential | LCSW
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Telephone | 917-597-3651
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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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