MEDICARE: YOCHEVED RAPPOPORT MHC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	P109342	NY

General Provider Information

NPI Number	:	1295408367
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YOCHEVED RAPPOPORT MHC

Provider Business Mailing Address
First Line	:	12 WOODWIND LN
Second Line	:
City	:	SPRING VALLEY
State	:	NY
Zip	:	10977-1614
Country	:	US
Telephone Number	:	347-420-0687
Fax Number	:

Provider Business Practice Location Address
First Line	:	3 MARCIA LN
Second Line	:
City	:	SPRING VALLEY
State	:	NY
Zip	:	10977-2018
Country	:	US
Telephone Number	:	347-420-0687
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/26/2021
Last Update Date	:	07/26/2021

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