=====================================================
General NPI Number Information
=====================================================
NPI Number | 1699989111
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MARGARET SOUZA LCSW
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/10/2007
-----------------------------------------------------
Last Update Date | 12/24/2016
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 26 COURT ST. SUITE 602 11242-1112
-----------------------------------------------------
City | BROOKLYN
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11242
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 347-596-4267
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 222 W 14TH ST APT 6K
-----------------------------------------------------
City | NEW YORK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10011-7208
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 718-436-8534
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number | R021768-1
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------