Healthcare Provider Details

I. General information

NPI: 1194651539
Provider Name (Legal Business Name): YOUR THERAPY CORNER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/23/2026
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

140 VAN CORTLANDT AVE W APT 1F
BRONX NY
10463-2706
US

IV. Provider business mailing address

140 VAN CORTLANDT AVE W APT 1F
BRONX NY
10463-2706
US

V. Phone/Fax

Practice location:
  • Phone: 914-510-2446
  • Fax: 914-217-1004
Mailing address:
  • Phone: 917-363-8796
  • Fax: 914-217-1004

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: KENISHA WEBER
Title or Position: LICENSED CLINICAL SOCIAL WORKER
Credential: LCSW
Phone: 917-363-8796