Blue Haven Confidential Counseling and Psychotherapy Services LCSW P.C

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

R0383781 Issued in NY

Legal business name

BLUE HAVEN CONFIDENTIAL COUNSELING AND PSYCHOTHERAPY SERVICES LCSW P.C

Practice address

6143 186TH St
Fresh Meadows, NY 11365-2710

Phone

(347) 506-3986

Fax

(718) 475-2122

NPI assigned

May 1, 2013

Organization subpart

No

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

Authorized official

Name

Ms. Dorothy Frazier, LCSW-R

Title

Director

Phone

(718) 415-3832

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1367366400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1367366400000",
    "number": "1881039022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20417 HILLSIDE AVE",
            "address_2": "SUITE 309",
            "city": "HOLLIS",
            "state": "NY",
            "postal_code": "114232213",
            "telephone_number": "347-506-3968",
            "fax_number": "718-475-2122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6143 186TH ST",
            "city": "FRESH MEADOWS",
            "state": "NY",
            "postal_code": "113652710",
            "telephone_number": "347-506-3986",
            "fax_number": "718-475-2122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE HAVEN CONFIDENTIAL COUNSELING AND PSYCHOTHERAPY SERVICES LCSW P.C",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-01",
        "last_updated": "2013-05-01",
        "status": "A",
        "authorized_official_last_name": "FRAZIER",
        "authorized_official_first_name": "DOROTHY",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "718-415-3832",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCSW-R"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R0383781",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Fresh Meadows, NY
• Providers in Fresh Meadows, 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 May 1, 2013; 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.