Coopersmith, Bruce L
Coopersmith, Bruce L is an individual health care provider with primary practice located at 146 Pike St , Port Jervis NY 12771-1808. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Coopersmith, Bruce L can be contacted via phone (845) 858-1456.Contact Information
Primary practice address
146 Pike St
Port Jervis NY 12771-1808
Phone: (845) 858-1456
Fax: (845) 858-1459
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | R034362-1 | New York |
Profile Details
| NPI number | 1891783049 |
|---|---|
| LBN Legal business name | Coopersmith, Bruce L |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 12th, 2005 |
| Last updated | Feb 28th, 2014 - about 10 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1891783049 | NPPES |
| New York | MEDICAID | 00542503 |
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