Provider Demographics
NPI:1548943111
Name:PARK AVENUE PSYCHOTHERAPY LCSW PC
Entity type:Organization
Organization Name:PARK AVENUE PSYCHOTHERAPY LCSW PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:HADDON
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:212-433-2384
Mailing Address - Street 1:100 PARK AVE FL 16
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10017-5538
Mailing Address - Country:US
Mailing Address - Phone:917-334-6069
Mailing Address - Fax:
Practice Address - Street 1:1221 BRICKELL AVE STE 900
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33131-3800
Practice Address - Country:US
Practice Address - Phone:212-433-2384
Practice Address - Fax:855-293-9912
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-10
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty