Healthcare Provider Details

I. General information

NPI: 1093087678
Provider Name (Legal Business Name): MICHELE MARIE NEUHAUS ATR-BC, LCAT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/30/2012
Last Update Date: 10/25/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8114 QUEENS BLVD
ELMHURST NY
11373-3789
US

IV. Provider business mailing address

3230 BELL BLVD
BAYSIDE NY
11361-1059
US

V. Phone/Fax

Practice location:
  • Phone: 718-577-5342
  • Fax:
Mailing address:
  • Phone: 718-631-7446
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number009934
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code221700000X
TaxonomyArt Therapist
License Number000147
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: