Basic Information
| Provider Information | |||||||||
| NPI: | 1346977634 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | HARLEM FAMILY SERVICES INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2 RIVERSIDE DR APT 5D | ||||||||
| Address2: | |||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100232526 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6466436332 | ||||||||
| FaxNumber: | 7188589493 | ||||||||
| Practice Location | |||||||||
| Address1: | 15 W 39TH ST FL 2 | ||||||||
| Address2: | |||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100180637 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2125646006 | ||||||||
| FaxNumber: | 2125643440 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/05/2022 | ||||||||
| LastUpdateDate: | 08/05/2022 | ||||||||
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| AuthorizedOfficialLastName: | BROOKS | ||||||||
| AuthorizedOfficialFirstName: | EMORY | ||||||||
| AuthorizedOfficialMiddleName: | X | ||||||||
| AuthorizedOfficialTitleorPosition: | BOARD MEMBER | ||||||||
| AuthorizedOfficialTelephone: | 6466436332 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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| AuthorizedOfficialCredential: | LCSW | ||||||||
| NPICertificationDate: | 08/04/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | Y | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.