| Mary Ng-tedjasukmana, Lcsw, Pllc | |
|
1863 W 8th St Brooklyn NY 11223-2549 | |
| (718) 395-2064 | |
| Not Available |
| Full Name | Mary Ng-tedjasukmana, Lcsw, Pllc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 1863 W 8th St, Brooklyn, New York |
| Authorized Official Name and Position | Mary Ng-tedjasukmana, Lcsw, Pllc (PSYCHOTHERAPIST/ LIFE COACH) |
| Authorized Official Contact | 7183952064 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mary Ng-tedjasukmana, Lcsw, Pllc 1863 W 8th St Brooklyn NY 11223-2549 Ph: (718) 395-2064 | Mary Ng-tedjasukmana, Lcsw, Pllc 1863 W 8th St Brooklyn NY 11223-2549 Ph: (718) 395-2064 |
| NPI Number | 1528583507 |
|---|---|
| Provider Enumeration Date | 08/10/2017 |
| Last Update Date | 07/21/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528583507 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 081483 (New York) | Secondary |
| 1041C0700X | Social Worker - Clinical | 44SC05712100 (New Jersey) | Primary |
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