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General NPI Number Information
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NPI Number | 1851805345
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Entity Type | Organization
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Legal Business Name | CLINICAL THERAPEUTIC SUPPORT LCSW PC
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Dates
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Enumeration Date | 11/21/2017
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Last Update Date | 08/02/2023
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Provider Practice Location Address
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Address Line | 57 W 57TH ST STE 1101
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City | NEW YORK
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State | NY
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Zip | 10019-2814
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Country | US
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Telephone | 917-373-4557
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Fax |
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Provider Business Mailing Address
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Address Line | 459 COLUMBUS AVE STE 124
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City | NEW YORK
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State | NY
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Zip | 10024-5129
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Country | US
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Telephone | 917-373-4557
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Fax |
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Authorized Official
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Title or Position | FOUNDER
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Name | GRETA GLEISSNER
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Credential | LCSW
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Telephone | 917-373-4557
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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 | 083457
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License Number State | NY
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