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NPI 1780152140

NPI 1780152140 : SUCCEED UP, LLC : MONSEY, NY

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General NPI Number Information
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    NPI Number           |    1780152140
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    Entity Type          |    Organization 
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    Legal Business Name  |    SUCCEED UP, LLC 
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Dates
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    Enumeration Date     |    11/05/2018
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    Last Update Date     |    11/05/2018
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Provider Practice Location Address
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    Address Line         |    20 SUNRISE DR 
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    City                 |    MONSEY
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    State                |    NY
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    Zip                  |    10952-3305
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    Country              |    US
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    Telephone            |    917-701-3618
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    20 SUNRISE DR 
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    City                 |    MONSEY
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    State                |    NY
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    Zip                  |    10952-3305
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    Country              |    US
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    Telephone            |    917-701-3618
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    Fax                  |    
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Authorized Official
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    Title or Position    |    PRESIDENT
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    Name                 |    MR. ISRAEL  OSTER 
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    Credential           |    
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    Telephone            |    917-701-3618
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    103T00000X
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    Taxonomy Name        |    Psychologist
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    License Number       |    
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    License Number State |    
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Taxonomy #2
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    Taxonomy Code        |    1041C0700X
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    Taxonomy Name        |    Clinical Social Worker
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    License Number       |    
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    License Number State |    
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Taxonomy #3
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    Taxonomy Code        |    101YM0800X
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    Taxonomy Name        |    Mental Health Counselor
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    License Number       |    
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    License Number State |    
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