| Organization Name: | SJG PSYCHOTHERAPY INC |
| NPI Number: | 1437207842 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | SUSAN GUIDA (PRESIDENT) |
| Mailing Address: | 626 Willis Ave Williston Park |
| State: | NY US |
| Postal Code: | 11596 |
| Phone Number: | 5166212854 |
| Fax Number: | 5166212854 |
| NPI Enumeration Date: | 01/08/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | R069724 1 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |