Provider Demographics
NPI:1700624236
Name:MATTHEW PIEKNIK LCSW
Entity type:Organization
Organization Name:MATTHEW PIEKNIK LCSW
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:PIEKNIK
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:917-891-0144
Mailing Address - Street 1:5 W 19TH ST FL 3
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-4238
Mailing Address - Country:US
Mailing Address - Phone:917-891-0144
Mailing Address - Fax:
Practice Address - Street 1:5 W 19TH ST FL 3
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-4238
Practice Address - Country:US
Practice Address - Phone:917-891-0144
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-18
Last Update Date:2024-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty