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NPI Code Detail

MEDICARE: REFRESH PSYCHOTHERAPY, LCSW, PLLC

MEDICARE: REFRESH PSYCHOTHERAPY, 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
11041C0700XClinical Social Worker

General Provider Information

NPI Number : 1831689603
Entity Type Code : Organization
Provider Name (Legal Business Name) : REFRESH PSYCHOTHERAPY, LCSW, PLLC
Provider Business Mailing Address
First Line : 159 20TH ST STE 1B
Second Line :
City : BROOKLYN
State : NY
Zip : 11232-1254
Country : US
Telephone Number : 646-685-4422
Fax Number : 516-218-7964
Provider Business Practice Location Address
First Line : 159 20TH ST STE 1B
Second Line :
City : BROOKLYN
State : NY
Zip : 11232-1254
Country : US
Telephone Number : 646-685-4499
Fax Number : 516-218-7964
Authorized Official
Title or Position : CEO
Name : MS. KEELEY TEEMSMA
Credential : LCSW
Telephone Number : 646-685-4422
Provider Enumeration Date : 05/16/2018
Last Update Date : 01/14/2021

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