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SHOREHAM PSYCHOTHERAPY SERVICES LCSW PLLC

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Company Details

Name: SHOREHAM PSYCHOTHERAPY SERVICES LCSW PLLC
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE LIMITED LIABILITY COMPANY
Status: Active
Date of registration: 17 Jun 2013 (12 years ago)
Entity Number: 4418833
ZIP code: 11786
County: Suffolk
Place of Formation: New York
Address: 45 ROUTE 25A, SUITE A2, SHOREHAM, NY, United States, 11786

DOS Process Agent

Name Role Address
THE LLC DOS Process Agent 45 ROUTE 25A, SUITE A2, SHOREHAM, NY, United States, 11786

National Provider Identifier

NPI Number:
1669860573

Authorized Person:

Name:
MARY LEE HASBROUCK
Role:
PRESIDENT
Phone:

Taxonomy:

Selected Taxonomy:
1041C0700X - Clinical Social Worker
Is Primary:
No
Selected Taxonomy:
1041C0700X - Clinical Social Worker
Is Primary:
Yes

Contacts:

Fax:
6318215056

Filings

Filing Number Date Filed Type Effective Date
130617000749 2013-06-17 ARTICLES OF ORGANIZATION 2013-06-17

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Date of last update: 26 Mar 2025

Sources: New York Secretary of State