Healthcare Provider Details

I. General information

NPI: 1023754280
Provider Name (Legal Business Name): ANNE-KENYA DUBUISSON MSED, MHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/10/2022
Last Update Date: 08/22/2025
Certification Date: 08/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

720 BEACH 20TH ST
FAR ROCKAWAY NY
11691-3502
US

IV. Provider business mailing address

16820 127TH AVE APT 2C
JAMAICA NY
11434-3116
US

V. Phone/Fax

Practice location:
  • Phone: 718-327-7002
  • Fax: 718-327-0668
Mailing address:
  • Phone: 646-314-1134
  • 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:
Title or Position:
Credential:
Phone: