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General NPI Number Information
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NPI Number | 1790302438
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Entity Type | Organization
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Legal Business Name | FIELDSTON COUNSELING, LCSW, PLLC
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Dates
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Enumeration Date | 06/29/2020
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Last Update Date | 10/20/2022
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Provider Practice Location Address
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Address Line | 3265 JOHNSON AVE STE 100
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City | BRONX
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State | NY
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Zip | 10463-3539
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Country | US
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Telephone | 646-204-6755
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Fax | 646-893-7767
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Provider Business Mailing Address
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Address Line | 3265 JOHNSON AVE STE 100
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City | BRONX
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State | NY
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Zip | 10463-3539
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Country | US
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Telephone | 646-204-6755
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Fax | 646-893-7767
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Authorized Official
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Title or Position | OWNER
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Name | MS. INGRID SHARON NUNEZ
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Credential | LCSW-R
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Telephone | 917-587-4819
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical 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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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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 | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number |
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License Number State |
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Taxonomy #4
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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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