| Integrative Psychotherapists Lcsw Llc | |
|
401 Bloomingdale Rd Ste 4 Staten Island NY 10309-2070 | |
| (718) 981-6158 | |
| (718) 981-6158 |
| Full Name | Integrative Psychotherapists Lcsw Llc |
|---|---|
| Speciality | Social Worker |
| Location | 401 Bloomingdale Rd Ste 4, Staten Island, New York |
| Authorized Official Name and Position | Elizabeth Ann Keeney (SOCIAL WORKER/PSYCHOTHERAPIST) |
| Authorized Official Contact | 7189816158 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Integrative Psychotherapists Lcsw Llc 380 Henderson Ave Staten Island NY 10310-1617 Ph: (718) 448-3093 | Integrative Psychotherapists Lcsw Llc 401 Bloomingdale Rd Ste 4 Staten Island NY 10309-2070 Ph: (718) 981-6158 |
| NPI Number | 1720575764 |
|---|---|
| Provider Enumeration Date | 04/16/2018 |
| Last Update Date | 04/16/2018 |
| Medicare PECOS PAC ID | 5294082376 |
|---|---|
| Medicare Enrollment ID | O20180719003704 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720575764 | NPI | - | NPPES |
| 02449970 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Elizabeth A Keeney |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1538214440 PECOS PAC ID: 6901922160 Enrollment ID: I20100924000436 |
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