Healthcare Provider Details

I. General information

NPI: 1649032194
Provider Name (Legal Business Name): ZACHARY WOHLBERG LMHC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/29/2024
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

874 42ND ST
BROOKLYN NY
11232-4073
US

IV. Provider business mailing address

874 42ND ST
BROOKLYN NY
11232-4073
US

V. Phone/Fax

Practice location:
  • Phone: 71-891-3706
  • Fax:
Mailing address:
  • Phone: 718-913-7065
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number017029
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: