Healthcare Provider Details

I. General information

NPI: 1437400504
Provider Name (Legal Business Name): CHRISTINA OLMO LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CHRISTINA TORRES MHC

II. Dates (important events)

Enumeration Date: 09/28/2012
Last Update Date: 09/28/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

97 AMITY ST 6TH FLOOR
BROOKLYN NY
11201-6004
US

IV. Provider business mailing address

97 AMITY ST 6TH FLOOR
BROOKLYN NY
11201-6004
US

V. Phone/Fax

Practice location:
  • Phone: 718-780-1065
  • Fax: 718-780-1087
Mailing address:
  • Phone: 718-780-1065
  • Fax: 718-780-1087

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number005221
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: