Basic Information
| Provider Information | |||||||||
| NPI: | 1962856401 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BILLINGY | ||||||||
| FirstName: | ROSELL | ||||||||
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| Credential: | LMSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1492 E 94TH ST | ||||||||
| Address2: | 2 | ||||||||
| City: | BROOKLYN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 112365010 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7186881421 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 9413 FLATLANDS AVE | ||||||||
| Address2: | |||||||||
| City: | BROOKLYN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 112363726 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7182721600 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/21/2016 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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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 | 104100000X | 091689 | NY | Y | Behavioral Health & Social Service Providers | Social Worker | 1041C0700X | 091689 | NY | N | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.