Provider Information for 1255898342
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PSYCHOTHERAPY AT HOME, LCSW, PLLC
Organization Subpart: NO
NPI: 1255898342
Last Updated: 2023-02-07
Certification Date: 2023-02-07
Certification Date: 2023-02-07
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1255898342 | ||||||||||||
| Enumeration Date | 2019-02-25 | ||||||||||||
| NPI Type | NPI-2 Organization | ||||||||||||
| Status | Active | ||||||||||||
| Authorized Official Information | Name: DANA J LEGRANDE LCSW Title: Owner Phone: 5163025645 | ||||||||||||
| Mailing Address | 700 FULTON ST APT M3 FARMINGDALE, NY 11735-3447 United States Phone: 516-302-5645 | Fax:631-647-2058 | ||||||||||||
| Primary Practice Address | 326 SEA CLIFF ST ISLIP TERRACE, NY 11752-1109 United States Phone: 516-302-5645 | Fax: | ||||||||||||
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