Provider Demographics
NPI:1871974261
Name:MILESTONE PSYCHOTHERAPY, LCSW, PC
Entity type:Organization
Organization Name:MILESTONE PSYCHOTHERAPY, LCSW, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SOCIAL WORKER/PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:HILDA
Authorized Official - Middle Name:R
Authorized Official - Last Name:HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:516-652-7014
Mailing Address - Street 1:2010 WILLIAMSBRIDGE RD
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10461-1603
Mailing Address - Country:US
Mailing Address - Phone:718-409-6000
Mailing Address - Fax:718-239-0039
Practice Address - Street 1:2010 WILLIAMSBRIDGE RD
Practice Address - Street 2:2ND FLOOR
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-1603
Practice Address - Country:US
Practice Address - Phone:718-409-6000
Practice Address - Fax:718-239-0039
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-11
Last Update Date:2015-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR049291-1261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)