Psychotherapy LCSW PC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

PSYCHOTHERAPY LCSW PC

Practice address

9029 218TH PL
Queens Village, NY 11428-1336

Phone

(347) 682-7023

Fax

(718) 454-5027

NPI assigned

Aug 16, 2018

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Adalgiza Sandoval, LCSWNPI 1245360189

Title

Owner

Phone

(347) 680-7023

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Adalgiza Sandoval, LCSW

  • Clinical Social Worker
  • Queens Village, NY
  • NPI 1245360189
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1534377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1534377600000",
    "number": "1063992345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9029 218TH PL",
            "city": "QUEENS VILLAGE",
            "state": "NY",
            "postal_code": "114281336",
            "telephone_number": "347-680-7023",
            "fax_number": "718-454-5027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9029 218TH PL",
            "city": "QUEENS VILLAGE",
            "state": "NY",
            "postal_code": "114281336",
            "telephone_number": "347-682-7023",
            "fax_number": "718-454-5027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSYCHOTHERAPY LCSW PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-16",
        "last_updated": "2018-08-16",
        "status": "A",
        "authorized_official_last_name": "SANDOVAL",
        "authorized_official_first_name": "ADALGIZA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "347-680-7023",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Queens Village, NY
• Providers in Queens Village, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.