| Proactive Counseling Lcsw P.c. | |
|
775 Brooklyn Ave North Baldwin NY 11510-2948 | |
| (917) 826-1644 | |
| (516) 704-2058 |
| Full Name | Proactive Counseling Lcsw P.c. |
|---|---|
| Speciality | Social Worker |
| Location | 775 Brooklyn Ave, North Baldwin, New York |
| Authorized Official Name and Position | Lea M Boriskin (OWNER) |
| Authorized Official Contact | 9178261644 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Proactive Counseling Lcsw P.c. 446 Walton St West Hempstead NY 11552-3051 Ph: (917) 826-1644 | Proactive Counseling Lcsw P.c. 775 Brooklyn Ave North Baldwin NY 11510-2948 Ph: (917) 826-1644 |
| NPI Number | 1700318847 |
|---|---|
| Provider Enumeration Date | 03/29/2017 |
| Last Update Date | 03/29/2017 |
| Medicare PECOS PAC ID | 0648540013 |
|---|---|
| Medicare Enrollment ID | O20170718000193 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700318847 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 078617 (New York) | Primary |
| Provider Name | Lea Boriskin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1154571396 PECOS PAC ID: 9739347311 Enrollment ID: I20120229000125 |
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