| Community Concern Lcsw Services, Pc | |
|
13420 87th Ave Apt 4d Richmond Hill NY 11418-1905 | |
| (646) 671-7581 | |
| (646) 968-9975 |
| Full Name | Community Concern Lcsw Services, Pc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 13420 87th Ave Apt 4d, Richmond Hill, New York |
| Authorized Official Name and Position | Tracey D Little (OWNER/PRACTITIONER) |
| Authorized Official Contact | 6466717581 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Community Concern Lcsw Services, Pc 20417 Hillside Ave Ste 332 Hollis NY 11423-2213 Ph: (646) 671-7581 | Community Concern Lcsw Services, Pc 13420 87th Ave Apt 4d Richmond Hill NY 11418-1905 Ph: (646) 671-7581 |
| NPI Number | 1851065064 |
|---|---|
| Provider Enumeration Date | 08/03/2021 |
| Last Update Date | 08/03/2021 |
| Certification Date | 08/03/2021 |
| Medicare PECOS PAC ID | 8628504099 |
|---|---|
| Medicare Enrollment ID | O20241209002084 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851065064 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Tracey D Little |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1558646448 PECOS PAC ID: 1254632847 Enrollment ID: I20151228001135 |
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