Healthcare Provider Details

I. General information

NPI: 1972324499
Provider Name (Legal Business Name): COSMOS MENTAL HEALTH COUNSELING LLP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/17/2024
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 MIDDLE COUNTRY RD STE 203F
CENTEREACH NY
11720-3577
US

IV. Provider business mailing address

418 BROADWAY # 8454
ALBANY NY
12207-2922
US

V. Phone/Fax

Practice location:
  • Phone: 631-291-2385
  • Fax:
Mailing address:
  • Phone: 631-291-2385
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: RACHEL HARTMAN
Title or Position: PARTNER
Credential:
Phone: 631-291-2385