Provider Demographics
NPI:1699544882
Name:ARMSTRONG, ACTIVEA (LMSW)
Entity type:Individual
Prefix:
First Name:ACTIVEA
Middle Name:
Last Name:ARMSTRONG
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8268 164TH ST # P409
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11432-1104
Mailing Address - Country:US
Mailing Address - Phone:718-883-2887
Mailing Address - Fax:718-334-5006
Practice Address - Street 1:8268 164TH ST # P409
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11432-1104
Practice Address - Country:US
Practice Address - Phone:718-883-2887
Practice Address - Fax:718-334-5006
Is Sole Proprietor?:No
Enumeration Date:2023-12-28
Last Update Date:2024-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
104100000X
NY121604104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker