Healthcare Provider Details

I. General information

NPI: 1417630989
Provider Name (Legal Business Name): GRACE OHAYON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2023
Last Update Date: 08/06/2025
Certification Date: 08/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1950 OCEAN AVE
BROOKLYN NY
11230-6719
US

IV. Provider business mailing address

1273 E 7TH ST
BROOKLYN NY
11230-4003
US

V. Phone/Fax

Practice location:
  • Phone: 212-613-8229
  • Fax:
Mailing address:
  • Phone: 917-692-8537
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberP134502
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: