Provider Demographics
NPI:1104276526
Name:WEE GROW LCSW PC
Entity type:Organization
Organization Name:WEE GROW LCSW PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOCIAL WORKER
Authorized Official - Prefix:MS
Authorized Official - First Name:SYLVIA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAIK
Authorized Official - Suffix:
Authorized Official - Credentials:MSW LCSW
Authorized Official - Phone:917-887-8906
Mailing Address - Street 1:203 CUMLEY TER
Mailing Address - Street 2:
Mailing Address - City:LEONIA
Mailing Address - State:NJ
Mailing Address - Zip Code:07605-1112
Mailing Address - Country:US
Mailing Address - Phone:917-887-8906
Mailing Address - Fax:201-346-1698
Practice Address - Street 1:203 CUMLEY TER
Practice Address - Street 2:
Practice Address - City:LEONIA
Practice Address - State:NJ
Practice Address - Zip Code:07605-1112
Practice Address - Country:US
Practice Address - Phone:917-887-8906
Practice Address - Fax:201-346-1698
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-16
Last Update Date:2016-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0321021251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare