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General NPI Number Information
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NPI Number | 1821341454
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Entity Type | Organization
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Legal Business Name | PROFESSIONAL COUNSELING SERVICES LCSW PLLC
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Dates
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Enumeration Date | 10/19/2012
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Last Update Date | 07/15/2015
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Provider Practice Location Address
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Address Line | 1009 BRIGHTON BEACH AVE 3RD FL.
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City | BROOKLYN
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State | NY
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Zip | 11235
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Country | US
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Telephone | 917-420-0301
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Fax | 718-676-4892
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Provider Business Mailing Address
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Address Line | 155 OCEANA DR. E #6F
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City | BROOKLYN
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State | NY
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Zip | 11235
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Country | US
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Telephone | 917-420-0301
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Fax | 718-676-4892
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Authorized Official
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Title or Position | OWNER/MEMBER LLC
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Name | ELLEN VERNY
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Credential | LCSW-R
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Telephone | 917-420-0301
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 055683
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License Number State | NY
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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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