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General NPI Number Information
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NPI Number | 1720311699
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Entity Type | Organization
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Legal Business Name | NATALYA LITVINOVA, LCSW, P.L.L.C.
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Dates
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Enumeration Date | 09/10/2009
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Last Update Date | 09/10/2009
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Provider Practice Location Address
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Address Line | 196 SAND LN
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City | STATEN ISLAND
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State | NY
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Zip | 10305-4503
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Country | US
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Telephone | 718-720-1453
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Fax |
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Provider Business Mailing Address
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Address Line | 196 SAND LN
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City | STATEN ISLAND
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State | NY
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Zip | 10305-4503
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Country | US
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Telephone | 718-720-1453
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Fax |
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Authorized Official
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Title or Position | PSYCHOTHERAPIST
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Name | NATALYA LITVINOVA
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Credential | LCSW-R
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Telephone | 718-720-1453
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | R069630
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License Number State | NY
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