Provider Demographics
NPI:1699151639
Name:ANTONOVSKY, CSILLA (LMHC)
Entity type:Individual
Prefix:
First Name:CSILLA
Middle Name:
Last Name:ANTONOVSKY
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3044 CONEY ISLAND AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-5660
Mailing Address - Country:US
Mailing Address - Phone:718-265-4200
Mailing Address - Fax:
Practice Address - Street 1:3044 CONEY ISLAND AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-5660
Practice Address - Country:US
Practice Address - Phone:718-265-4200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-31
Last Update Date:2015-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health