Healthcare Provider Details

I. General information

NPI: 1689422552
Provider Name (Legal Business Name): DAYSPRING MENTAL HEALTH COUNSELING, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/07/2024
Last Update Date: 05/07/2024
Certification Date: 05/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10525 67TH AVE
FOREST HILLS NY
11375-2161
US

IV. Provider business mailing address

7211 AUSTIN ST # 407
FOREST HILLS NY
11375-5354
US

V. Phone/Fax

Practice location:
  • Phone: 347-263-7623
  • Fax:
Mailing address:
  • Phone: 347-263-7623
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code221700000X
TaxonomyArt Therapist
License Number
License Number State

VIII. Authorized Official

Name: DR. VICTORIA MOON LING CHIU
Title or Position: OWNER & SENIOR THERAPIST
Credential: PHD, LMHC, LMFT
Phone: 347-263-7623