Basic Information
| Provider Information | |||||||||
| NPI: | 1487709945 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BEARMAN | ||||||||
| FirstName: | SELINE | ||||||||
| MiddleName: | L | ||||||||
| NamePrefix: | PROF. | ||||||||
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| Credential: | LCSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6506 110TH ST | ||||||||
| Address2: | |||||||||
| City: | FOREST HILLS | ||||||||
| State: | NY | ||||||||
| PostalCode: | 113751424 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7185441668 | ||||||||
| FaxNumber: | 7185914397 | ||||||||
| Practice Location | |||||||||
| Address1: | 7150 PARSONS BLVD | ||||||||
| Address2: | |||||||||
| City: | FLUSHING | ||||||||
| State: | NY | ||||||||
| PostalCode: | 113654131 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7185916750 | ||||||||
| FaxNumber: | 7185914397 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/24/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | R047159-1 | NY | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.