MEDICARE: MUSTARD SEED SURVIVOR EMPOWERMENT FOUNDATION

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	R055343	NY

General Provider Information

NPI Number	:	1386955946
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MUSTARD SEED SURVIVOR EMPOWERMENT FOUNDATION

Provider Business Mailing Address
First Line	:	2625 ATLANTIC AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11207-2407
Country	:	US
Telephone Number	:	718-875-7411
Fax Number	:

Provider Business Practice Location Address
First Line	:	1118 BEDFORD AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11216-1303
Country	:	US
Telephone Number	:	718-875-7425
Fax Number	:

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	SCOTT JOHNSON
Credential	:	J.D.
Telephone Number	:	718-875-7425

Provider Enumeration Date	:	06/29/2010
Last Update Date	:	04/02/2019

Similar Medicare Providers

1710382064 — CENTER FOR ALL SEASONS, INC
Practice Location Address:

1118 BEDFORD AVE
BROOKLYN, NY
11216-1303

Practice Phone: 718-875-7425
Practice Fax:

1588029607 — NIKITA L BANKS LCSW
Practice Location Address:

1118 BEDFORD AVE
BROOKLYN, NY
11216-1303

Practice Phone: 347-566-5629
Practice Fax:

1790294650 — MR. KEVIN TODD BROTHERS LMSW
Practice Location Address:

1118 BEDFORD AVE
BROOKLYN, NY
11216-1303

Practice Phone: 718-875-7411
Practice Fax: 718-643-1840

1285204354 — VICTORIA LICANDRO
Practice Location Address:

26 COURT ST STE 1303
BROOKLYN, NY
11242-1113

Practice Phone: 845-709-7390
Practice Fax:

1063345114 — MAYA LEVINE
Practice Location Address:

26 COURT ST STE 1303
BROOKLYN, NY
11242-1113

Practice Phone: 917-476-9381
Practice Fax:

1376503383 — DR. GEORGE M MALEGIANNAKIS MD
Practice Location Address:

1811 AVENUE P , SUITE # 1A
BROOKLYN, NY
11229-1303

Practice Phone: 718-375-7595
Practice Fax: 718-375-7559

Directions to “MUSTARD SEED SURVIVOR EMPOWERMENT FOUNDATION ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.