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NPI Code Detail

MEDICARE: AITIA MENTAL HEALTH COUNSELING PLLC

MEDICARE: AITIA MENTAL HEALTH COUNSELING PLLC
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
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1932799582
Entity Type Code : Organization
Provider Name (Legal Business Name) : AITIA MENTAL HEALTH COUNSELING PLLC
Provider Business Mailing Address
First Line : 928 BROADWAY STE 803
Second Line :
City : NEW YORK
State : NY
Zip : 10010-8125
Country : US
Telephone Number : 646-535-1236
Fax Number :
Provider Business Practice Location Address
First Line : 928 BROADWAY STE 803
Second Line :
City : NEW YORK
State : NY
Zip : 10010-8125
Country : US
Telephone Number : 646-535-1236
Fax Number :
Authorized Official
Title or Position : OWNER/THERAPIST
Name : DR. DAMIEN ALEXANDER DUPONT
Credential : PHD
Telephone Number : 646-535-1236
Provider Enumeration Date : 01/18/2021
Last Update Date : 03/27/2023

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