| NPI | 1295259893 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EBONY LSW, ACSW, CAMS-II, CGT Adminstrator 267-343-5327 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101Y00000X Counselor |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2017-07-26 |
| Last Update Date | 2024-09-03 |