MEDICARE: CHANEL WEATHERS LMHC

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	101Y00000X	Counselor		NY

General Provider Information

NPI Number	:	1699551325
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHANEL WEATHERS LMHC

Provider Business Mailing Address
First Line	:	142 OVERLOOK ST
Second Line	:
City	:	MOUNT VERNON
State	:	NY
Zip	:	10552-3352
Country	:	US
Telephone Number	:	718-404-2396
Fax Number	:

Provider Business Practice Location Address
First Line	:	142 OVERLOOK ST
Second Line	:
City	:	MOUNT VERNON
State	:	NY
Zip	:	10552-3352
Country	:	US
Telephone Number	:	718-404-2396
Fax Number	:

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

Provider Enumeration Date	:	09/07/2023
Last Update Date	:	06/05/2026

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Directions to “ CHANEL WEATHERS LMHC” Practice Location

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