MR. John Francis Provost, LCSW LICENSED CERTIF

NPI #1023129947 in Hauppauge, New York

Provider Information

NPI Number: 1023129947
Entity Type: Individual
Name: MR. John Francis Provost, LCSW LICENSED CERTIF
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Social Worker - Clinical
Credential: LCSW LICENSED CERTIF
Enumeration Date: Aug 31, 2006
Last Updated: Jul 8, 2007

Practice Location

Address: 750 VETERANS HIGHWAY
Address 2: SUITE 205
City: Hauppauge
State: New York
ZIP Code: 11788-2943
Phone: (631) 724-5522

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Social Worker - Clinical — Clinical	1041C0700X	Primary

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