Healthcare Provider Details

I. General information

NPI: 1952272981
Provider Name (Legal Business Name): ASHLEIGH MARIE HEYDER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/15/2025
Last Update Date: 09/15/2025
Certification Date: 09/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

521 BERGEN AVE
BRONX NY
10455-4010
US

IV. Provider business mailing address

1859 FLATBUSH AVE
BROOKLYN NY
11210-4872
US

V. Phone/Fax

Practice location:
  • Phone: 908-868-9811
  • Fax: 908-868-9811
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: