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General NPI Number Information
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NPI Number | 1891200101
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Entity Type | Organization
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Legal Business Name | OPEN SOURCE THERAPY & COUNSELING
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Dates
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Enumeration Date | 12/08/2017
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 117 DOBBIN ST STE 206
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City | BROOKLYN
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State | NY
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Zip | 11222-2803
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Country | US
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Telephone | 347-309-8548
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Fax |
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Provider Business Mailing Address
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Address Line | 645 MORGAN AVE STE 1
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City | BROOKLYN
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State | NY
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Zip | 11222-3709
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Country | US
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Telephone | 347-309-8548
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CHRISTINA R KARLOWSKI
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Credential | LCSW
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Telephone | 347-309-8548
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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 | 083877
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License Number State | NY
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