Provider Type Icon

AFFECTIVE LCSW SERVICES PLLC NPI 1205257417


NPI Information

NPI: 1205257417
Provider Name: AFFECTIVE LCSW SERVICES PLLC

Doing Business As: AFFECTIVE LCSW SERVICES

Classification: Social Worker - 1041C0700X
Entity Type: Organization

Specialization: Clinical

Address:
97 BUSH AVE
STATEN ISLAND, NY
ZIP 10303
Phone: (347) 788-3775
Get Directions

AFFECTIVE LCSW SERVICES PLLC is a clinical social worker in Staten Island, NY. The provider is a social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. AFFECTIVE LCSW SERVICES PLLC NPI is 1205257417. The provider is registered as an organization entity type and is a multiple single specialty group.
The provider Is Doing Business As Affective Lcsw Services.

The provider's business location address is:

97 BUSH AVE
STATEN ISLAND, NY
ZIP 10303-215
Phone: (347) 788-3775
Fax: (718) 420-1032

The provider's authorized official is Delsa Johnson Fauconier .
The authorized official title is President/ceo and has the following contact phone number (347) 788-3775.

The enumeration date for this NPI number is 12/16/2013 and was last updated on 8/18/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1104100000XSocial Worker083062NEW YORKNo
2104100000XSocial Worker087435NEW YORKNo
31041C0700XSocial WorkerClinicalNo
41041C0700XSocial WorkerClinical075416NEW YORKYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
103546563MEDICAIDNEW YORK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.