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NPI Code Detail

MEDICARE: WORK IN PROGRESS THERAPEUTIC SERVICES LCSW P.L.L.C

MEDICARE: WORK IN PROGRESS THERAPEUTIC SERVICES LCSW P.L.L.C
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
11041C0700XClinical Social Worker081627NY

General Provider Information

NPI Number : 1376957654
Entity Type Code : Organization
Provider Name (Legal Business Name) : WORK IN PROGRESS THERAPEUTIC SERVICES LCSW P.L.L.C
Provider Business Mailing Address
First Line : 207 FREDERICK AVE
Second Line :
City : ROOSEVELT
State : NY
Zip : 11575-2333
Country : US
Telephone Number : 516-710-0235
Fax Number :
Provider Business Practice Location Address
First Line : 1259 WANTAGH AVE
Second Line :
City : WANTAGH
State : NY
Zip : 11793-2205
Country : US
Telephone Number : 516-710-0235
Fax Number :
Authorized Official
Title or Position : OWNER
Name : CHERYLANN MCCALLA
Credential : LCSW
Telephone Number : 516-710-0235
Provider Enumeration Date : 06/16/2014
Last Update Date : 08/22/2015

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Directions to “WORK IN PROGRESS THERAPEUTIC SERVICES LCSW P.L.L.C ” Practice Location

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