Provider Demographics
NPI:1215331079
Name:NEW HORIZONS LCSW, PC
Entity type:Organization
Organization Name:NEW HORIZONS LCSW, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ANA
Authorized Official - Middle Name:
Authorized Official - Last Name:CARRION
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LCSW-R
Authorized Official - Phone:631-617-5300
Mailing Address - Street 1:12 GATEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:HAUPPAUGE
Mailing Address - State:NY
Mailing Address - Zip Code:11788-1011
Mailing Address - Country:US
Mailing Address - Phone:631-617-5300
Mailing Address - Fax:888-272-0686
Practice Address - Street 1:12 GATEWOOD DR
Practice Address - Street 2:
Practice Address - City:HAUPPAUGE
Practice Address - State:NY
Practice Address - Zip Code:11788-1011
Practice Address - Country:US
Practice Address - Phone:631-617-5300
Practice Address - Fax:888-272-0686
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-22
Last Update Date:2014-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY049144-1104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty