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NPI Code Detail

MEDICARE: BLUE SPRING LCSW PLLC

MEDICARE: BLUE SPRING LCSW 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
1261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number : 1356298731
Entity Type Code : Organization
Provider Name (Legal Business Name) : BLUE SPRING LCSW PLLC
Provider Business Mailing Address
First Line : 2310 JERICHO TPKE # 1060
Second Line :
City : GARDEN CITY PARK
State : NY
Zip : 11040-4721
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 475 NORTHERN BLVD STE 12
Second Line :
City : GREAT NECK
State : NY
Zip : 11021-4802
Country : US
Telephone Number : 646-801-6368
Fax Number :
Authorized Official
Title or Position : OWNER
Name : MIAOYING ZHU
Credential :
Telephone Number : 917-828-6878
Provider Enumeration Date : 03/13/2026
Last Update Date : 05/17/2026

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Directions to “BLUE SPRING LCSW PLLC ” Practice Location

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