MEDICARE: SYBIL NURSE-REEVES LCSW COUNSELING SERVICES, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	R045601-1	NY

General Provider Information

NPI Number	:	1033634050
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SYBIL NURSE-REEVES LCSW COUNSELING SERVICES, PLLC

Provider Business Mailing Address
First Line	:	13130 MERRICK BLVD
Second Line	:
City	:	JAMAICA
State	:	NY
Zip	:	11434-4134
Country	:	US
Telephone Number	:	718-233-2556
Fax Number	:	718-233-2569

Provider Business Practice Location Address
First Line	:	13130 MERRICK BLVD
Second Line	:
City	:	JAMAICA
State	:	NY
Zip	:	11434-4134
Country	:	US
Telephone Number	:	718-233-2556
Fax Number	:	718-233-2569

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. SYBIL NURSE-REEVES
Credential	:	LCSW
Telephone Number	:	718-233-2556

Provider Enumeration Date	:	08/10/2017
Last Update Date	:	03/19/2024

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