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General NPI Number Information
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NPI Number | 1982362547
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Entity Type | Organization
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Legal Business Name | METRO PSYCHOTHERAPY COUNSELING LCSW PLLC
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Dates
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Enumeration Date | 12/01/2021
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Last Update Date | 12/01/2021
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Provider Practice Location Address
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Address Line | 259 WALT WHITMAN RD
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City | HUNTINGTON STATION
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State | NY
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Zip | 11746-4119
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Country | US
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Telephone | 516-582-3515
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Fax |
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Provider Business Mailing Address
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Address Line | 14 FOX HOLLOW LN
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City | OLD WESTBURY
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State | NY
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Zip | 11568-1331
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Country | US
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Telephone | 516-582-3515
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | LUCAS MAYRSOHN
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Credential | LCSW
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Telephone | 516-582-3515
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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 |
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License Number State |
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