| Setauket Licensed Clinical Social Work Consultation Services Pllc | |
|
100 S Jersey Ave Unit 42 East Setauket NY 11733-2034 | |
| (631) 689-1728 | |
| Not Available |
| Full Name | Setauket Licensed Clinical Social Work Consultation Services Pllc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 100 S Jersey Ave, East Setauket, New York |
| Authorized Official Name and Position | Paul Botticelli (DIRECTOR) |
| Authorized Official Contact | 6316891728 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Setauket Licensed Clinical Social Work Consultation Services Pllc 100 S Jersey Ave Unit 42 East Setauket NY 11733-2034 Ph: (631) 689-1728 | Setauket Licensed Clinical Social Work Consultation Services Pllc 100 S Jersey Ave Unit 42 East Setauket NY 11733-2034 Ph: (631) 689-1728 |
| NPI Number | 1801073184 |
|---|---|
| Provider Enumeration Date | 01/29/2008 |
| Last Update Date | 05/13/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801073184 | NPI | - | NPPES |
| 501512 | Other | NY | VALUE OPTIONS |
| 7336094 | Other | NY | GHI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | R0276581 (New York) | Primary |
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