Healthcare Provider Details

I. General information

NPI: 1306387824
Provider Name (Legal Business Name): TIFFANY SACHMECHI LMHC, NCC, CASAC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/16/2017
Last Update Date: 11/25/2020
Certification Date: 11/25/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14202 20TH AVE
FLUSHING NY
11351-3000
US

IV. Provider business mailing address

203B W SHORE RD
GREAT NECK NY
11024-1624
US

V. Phone/Fax

Practice location:
  • Phone: 917-563-3350
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number010412
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: