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General NPI Number Information
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NPI Number | 1699289835
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Entity Type | Organization
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Legal Business Name | L I COUNSELING & SOCIAL WORK PC
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Dates
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Enumeration Date | 11/27/2017
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Last Update Date | 04/24/2024
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Provider Practice Location Address
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Address Line | 3187 ANN ST
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City | BALDWIN
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State | NY
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Zip | 11510-4509
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Country | US
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Telephone | 516-236-9111
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Fax | 516-223-0332
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Provider Business Mailing Address
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Address Line | 3187 ANN ST
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City | BALDWIN
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State | NY
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Zip | 11510-4509
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Country | US
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Telephone | 516-236-9111
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. JACKIE LYNN ZUCKERMAN
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Credential | LCSW
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Telephone | 516-236-9111
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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 | R031960-1
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License Number State | NY
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