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General NPI Number Information
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NPI Number | 1992074751
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Entity Type | Organization
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Legal Business Name | LIFESKILLS & PSYCHOTHERAPY SERVICES,PC
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Dates
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Enumeration Date | 12/23/2011
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Last Update Date | 12/23/2011
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Provider Practice Location Address
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Address Line | 18 FOREST RD
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City | CENTEREACH
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State | NY
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Zip | 11720-2244
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Country | US
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Telephone | 631-648-7689
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Fax | 631-648-7690
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Provider Business Mailing Address
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Address Line | 18 FOREST RD
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City | CENTEREACH
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State | NY
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Zip | 11720-2244
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Country | US
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Telephone | 631-648-7689
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Fax | 631-648-7690
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Authorized Official
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Title or Position | OWNER
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Name | MS. DIANE O SEAMAN
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Credential | LCSW, BCD,
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Telephone | 631-648-7689
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP1600X
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Taxonomy Name | Pastoral Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | R0270991
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License Number State | NY
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