Healthcare Provider Details

I. General information

NPI: 1356965446
Provider Name (Legal Business Name): JOANNA OCASIO-JANVIER MHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/03/2020
Last Update Date: 06/03/2020
Certification Date: 06/03/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

657 E 233RD ST
BRONX NY
10466-2801
US

IV. Provider business mailing address

657 E 233RD ST
BRONX NY
10466-2801
US

V. Phone/Fax

Practice location:
  • Phone: 914-502-6664
  • Fax: 347-694-4958
Mailing address:
  • Phone: 718-944-1414
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberP105243
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: