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General NPI Number Information
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NPI Number | 1730885591
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Entity Type | Organization
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Legal Business Name | WHOLENESS PSYCHOTHERAPY LCSW LLC
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Dates
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Enumeration Date | 02/03/2023
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Last Update Date | 02/03/2023
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Provider Practice Location Address
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Address Line | 5 UNION SQ W # 1053
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City | NEW YORK
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State | NY
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Zip | 10003-3306
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Country | US
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Telephone | 929-324-1058
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Fax |
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Provider Business Mailing Address
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Address Line | 5 UNION SQ W # 1053
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City | NEW YORK
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State | NY
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Zip | 10003-3306
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Country | US
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Telephone | 929-324-1058
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Fax |
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Authorized Official
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Title or Position | BUSINESS OWNER
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Name | FATIMA WALKER
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Credential | LCSW
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Telephone | 347-351-1397
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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