| Counseling Services Of Long Island Lcsw Pc | |
|
54 Chicago Ave Massapequa NY 11758-4422 | |
| (516) 528-6712 | |
| (516) 804-0448 |
| Full Name | Counseling Services Of Long Island Lcsw Pc |
|---|---|
| Speciality | Clinic/Center |
| Location | 54 Chicago Ave, Massapequa, New York |
| Authorized Official Name and Position | Penny Siegmann-beiner (OWNER) |
| Authorized Official Contact | 5165286712 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Counseling Services Of Long Island Lcsw Pc 54 Chicago Ave Massapequa NY 11758-4422 Ph: () - | Counseling Services Of Long Island Lcsw Pc 54 Chicago Ave Massapequa NY 11758-4422 Ph: (516) 528-6712 |
| NPI Number | 1760982078 |
|---|---|
| Provider Enumeration Date | 02/14/2018 |
| Last Update Date | 02/14/2018 |
| Medicare PECOS PAC ID | 6507128816 |
|---|---|
| Medicare Enrollment ID | O20180327000888 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760982078 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Penny E Siegmann-beiner |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1730175738 PECOS PAC ID: 3173716750 Enrollment ID: I20101015000739 |
| Provider Name | Kenneth Beiner |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326493826 PECOS PAC ID: 2567840317 Enrollment ID: I20220607001031 |
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