Healthcare Provider Details

I. General information

NPI: 1689953739
Provider Name (Legal Business Name): MILESTONES MENTAL HEALTH COUNSELING PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/08/2011
Last Update Date: 08/08/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

571 EAST NEW YORK AVENUE, OFFICE B
BROOKLYN NY
11225
US

IV. Provider business mailing address

571 EAST NEW YORK AVENUE, OFFICE B
BROOKLYN NY
11225
US

V. Phone/Fax

Practice location:
  • Phone: 347-663-9027
  • Fax: 347-436-9027
Mailing address:
  • Phone: 347-663-9027
  • Fax: 347-436-9027

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MRS. DEVORAH DAVIDSON
Title or Position: DIRECTOR
Credential:
Phone: 347-663-9027