Healthcare Provider Details

I. General information

NPI: 1992401434
Provider Name (Legal Business Name): JOEY SUK HAHM MHC-LP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/06/2023
Last Update Date: 02/06/2023
Certification Date: 02/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2294 E 15TH ST
BROOKLYN NY
11229-4640
US

IV. Provider business mailing address

7 ALBERMARLE AVE
HUNTINGTN STA NY
11746-1932
US

V. Phone/Fax

Practice location:
  • Phone: 347-620-3330
  • Fax:
Mailing address:
  • Phone: 646-621-9800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberP118803
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: