Affective Lcsw Services

LBN: Affective Lcsw Services Pllc
Affective Lcsw Services is an health care organization with primary practice located at 97 Bush Ave , Staten Island NY 10303-2215. The organization recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Social Worker, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is the primary health care specialty. Affective Lcsw Services Pllc can be contacted via phone (347) 788-3775, or through Fauconier, Delsa Johnson via phone (347) 788-3775.

Contact Information

Primary practice address
97 Bush Ave Staten Island NY 10303-2215
Phone: (347) 788-3775
Fax: (718) 420-1032
Website:
Map and Directions
Authorized official contact:
Name: Fauconier, Delsa Johnson LCSW-R
Phone: (347) 788-3775

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Social Worker 104100000X 083062 New York
Behavioral Health & Social Service Providers / Social Worker 104100000X 087435 New York
Behavioral Health & Social Service Providers / Clinical 1041C0700X 075416 New York
Behavioral Health & Social Service Providers / Clinical 1041C0700X

Profile Details

NPI number 1205257417
LBN Legal business name Affective Lcsw Services Pllc
DBA Doing business as Affective Lcsw Services
Authorized official Fauconier, Delsa Johnson LCSW-R
Entity Organization
Organization subpart 1 No
Enumeration date Dec 16th, 2013
Last updated Aug 18th, 2021 - about 3 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1205257417 NPPES
New York MEDICAID 03546563

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