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General NPI Number Information
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NPI Number | 1710694930
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Entity Type | Organization
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Legal Business Name | YELLOW BIRD PSYCHOTHERAPY LCSW PC
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Dates
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Enumeration Date | 10/28/2022
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Last Update Date | 10/28/2022
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Provider Practice Location Address
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Address Line | 35 Seacoast Terrace 7G
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City | Brooklyn NY
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State | NY
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Zip | 11235
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Country | US
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Telephone | 6467613743
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Fax |
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Provider Business Mailing Address
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Address Line | 35 Seacoast Terrace 7G
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City | Brooklyn NY
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State | NY
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Zip | 11235
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Country | US
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Telephone | 6467613743
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | EKATERINA MOZER
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Credential | LCSW
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Telephone | 646-761-3743
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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 | 086079-01
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License Number State | NY
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Taxonomy #2
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Taxonomy Code |
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Taxonomy Name | Credentialed Alcoholism and Substance Abuse Counselor
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License Number | 29536
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License Number State | NY
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