Healthcare Provider Details

I. General information

NPI: 1790846632
Provider Name (Legal Business Name): HEATHER LABIANCA HARTEN LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HEATHER MARIE LABIANCA

II. Dates (important events)

Enumeration Date: 12/13/2006
Last Update Date: 09/29/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2201 HEMPSTEAD TURNPIKE
EAST MEADOW NY
11554
US

IV. Provider business mailing address

2201 HEMPSTEAD TURNPIKE
EAST MEADOW NY
11554
US

V. Phone/Fax

Practice location:
  • Phone: 516-486-6862
  • Fax: 718-633-4256
Mailing address:
  • Phone: 516-486-6862
  • Fax: 718-630-7437

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number11003
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number055489
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberR055489-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: