Provider Demographics
NPI:1427682541
Name:PHILIP, ASHA (LCSW)
Entity type:Individual
Prefix:
First Name:ASHA
Middle Name:
Last Name:PHILIP
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:260 W MAIN ST STE 8
Mailing Address - Street 2:
Mailing Address - City:BAY SHORE
Mailing Address - State:NY
Mailing Address - Zip Code:11706-8322
Mailing Address - Country:US
Mailing Address - Phone:631-647-9009
Mailing Address - Fax:631-647-8992
Practice Address - Street 1:3010 W 33RD ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11224-1404
Practice Address - Country:US
Practice Address - Phone:631-647-9009
Practice Address - Fax:631-647-8992
Is Sole Proprietor?:No
Enumeration Date:2020-02-27
Last Update Date:2020-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical