=====================================================
General NPI Number Information
=====================================================
NPI Number | 1801348776
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | THE RELATIONSHIP PROJECT
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/26/2016
-----------------------------------------------------
Last Update Date | 10/26/2016
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 928 BROADWAY STE 1206
-----------------------------------------------------
City | NEW YORK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10010-8109
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 646-898-9460
-----------------------------------------------------
Fax | 252-377-4231
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 928 BROADWAY STE 1206
-----------------------------------------------------
City | NEW YORK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10010-8109
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 646-898-9460
-----------------------------------------------------
Fax | 252-377-4231
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER PROVIDER
-----------------------------------------------------
Name | DIANA GASPERONI
-----------------------------------------------------
Credential | LCSW
-----------------------------------------------------
Telephone | 646-898-9460
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number | 078196
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------