Healthcare Provider Details

I. General information

NPI: 1649117573
Provider Name (Legal Business Name): ON MY MIND COUNSELING LMHC PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/29/2026
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

169 BEACH 134TH ST
BELLE HARBOR NY
11694-1437
US

IV. Provider business mailing address

533 BEACH 126TH ST
ROCKAWAY PARK NY
11694-1770
US

V. Phone/Fax

Practice location:
  • Phone: 917-648-8339
  • Fax:
Mailing address:
  • Phone: 917-648-8339
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: DIANA SAFYAN
Title or Position: OWNER
Credential:
Phone: 917-648-8339