Healthcare Provider Details

I. General information

NPI: 1023750312
Provider Name (Legal Business Name): DANIELLE RAWDA LMHC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/08/2022
Last Update Date: 03/04/2025
Certification Date: 03/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

255 15TH ST
BROOKLYN NY
11215-4988
US

IV. Provider business mailing address

255 15TH ST
BROOKLYN NY
11215-4988
US

V. Phone/Fax

Practice location:
  • Phone: 929-279-2528
  • Fax:
Mailing address:
  • Phone: 929-279-2528
  • Fax: 718-691-4021

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: DANIELLE RAWDA
Title or Position: PRIVATE PRACTICE PSYCHOTHERAPIST
Credential: LMHC
Phone: 929-279-2528