| St George Counseling Services Lcsw Pllc | |
|
120 Stuyvesant Pl Ste 423 Staten Island NY 10301-1989 | |
| (718) 447-7422 | |
| (718) 447-7421 |
| Full Name | St George Counseling Services Lcsw Pllc |
|---|---|
| Speciality | Social Worker |
| Location | 120 Stuyvesant Pl Ste 423, Staten Island, New York |
| Authorized Official Name and Position | Patricia Ann Thompson (PRESIDENT/CLINICAL DIRECTOR) |
| Authorized Official Contact | 7184477422 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| St George Counseling Services Lcsw Pllc Po Box 10980 Staten Island NY 10301-0980 Ph: (718) 447-7422 | St George Counseling Services Lcsw Pllc 120 Stuyvesant Pl Ste 423 Staten Island NY 10301-1989 Ph: (718) 447-7422 |
| NPI Number | 1134846207 |
|---|---|
| Provider Enumeration Date | 10/20/2022 |
| Last Update Date | 10/20/2022 |
| Certification Date | 10/20/2022 |
| Medicare PECOS PAC ID | 9638547532 |
|---|---|
| Medicare Enrollment ID | O20221128001298 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134846207 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Patricia Ann Thompson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700020443 PECOS PAC ID: 1557597572 Enrollment ID: I20131122000336 |
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