Healthcare Provider Details
I. General information
NPI: 1427895721
Provider Name (Legal Business Name): ZALTA MENTAL HEALTH COUNSELING PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/12/2024
Last Update Date: 07/12/2024
Certification Date: 07/12/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1637 E 21ST ST
BROOKLYN NY
11210-5037
US
IV. Provider business mailing address
1637 E 21ST ST
BROOKLYN NY
11210-5037
US
V. Phone/Fax
- Phone: 732-337-6443
- Fax:
- Phone: 732-337-6443
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
SAUL
M
ZALTA
Title or Position: OWNER
Credential: LMHC
Phone: 732-337-6443