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General NPI Number Information
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NPI Number | 1871644880
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Entity Type | Individual
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Provider Name | ADELE I AGIN LCSW
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Gender | Female
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Dates
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Enumeration Date | 01/16/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | LEXINGTON CENTER FOR MENTAL HEALTH SERVICES, INC. 30TH AVE & 75TH STREET
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City | JACKSON HEIGHTS
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State | NY
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Zip | 11370
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Country | US
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Telephone | 718-350-3110
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Fax | 718-350-3072
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Provider Business Mailing Address
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Address Line | 2621 UNION ST APT 1H
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City | FLUSHING
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State | NY
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Zip | 11354-1748
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Country | US
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Telephone | 718-460-2216
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 073641
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License Number State | NY
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