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General NPI Number Information
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NPI Number | 1669904645
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Entity Type | Organization
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Legal Business Name | BROADHOLLOW PSYCHOTHERAPY LCSW PLLC
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Dates
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Enumeration Date | 03/30/2017
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Last Update Date | 04/08/2025
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Provider Practice Location Address
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Address Line | 565 BROADHOLLOW RD STE 6E
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City | FARMINGDALE
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State | NY
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Zip | 11735-4830
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Country | US
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Telephone | 631-771-6996
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Fax | 631-991-9125
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Provider Business Mailing Address
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Address Line | 565 BROADHOLLOW RD STE 6E
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City | FARMINGDALE
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State | NY
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Zip | 11735-4830
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Country | US
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Telephone | 631-664-7488
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Fax | 631-991-9125
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Authorized Official
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Title or Position | OWNER
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Name | SHERI-ANN N BEST
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Credential |
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Telephone | 631-664-7488
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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 | 076794
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License Number State | NY
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