Organization · NPI-2
Irene Sofia Therapy Lcsw PC
Clinic/Center, Mental Health (Including Community Mental Health Center) · Ozone Park, NY
NPI number1306649470
StatusActive
Last updated in NPPESApr 1, 2025
Details
- NPI
- 1306649470
- Entity type
- Organization (NPI-2)
- Legal business name
- Irene Sofia Therapy Lcsw PC
- Organization subpart
- No
- Enumeration date
- Apr 1, 2025
- Certification date
- Mar 31, 2025
- Last updated
- Apr 1, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QM0801X | Clinic/Center, Mental Health (Including Community Mental Health Center) | – | – | Yes |
Practice location
13430 Sitka StOzone Park, NY 11417-2436
Phone 347-403-2102
Mailing address
13430 Sitka StOzone Park, NY 11417-2436
Phone 347-403-2102
Authorized official
Irene Sofia Koutsidis-Martelli
Supervisor/Owner
3472564597
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