Healthcare Provider Details

I. General information

NPI: 1326823691
Provider Name (Legal Business Name): COUNSELING OF LONG ISLAND
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2023
Last Update Date: 08/25/2023
Certification Date: 08/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 FRANKLIN AVE STE 200
GARDEN CITY NY
11530-5760
US

IV. Provider business mailing address

601 FRANKLIN AVE STE 200
GARDEN CITY NY
11530-5760
US

V. Phone/Fax

Practice location:
  • Phone: 516-286-1188
  • Fax:
Mailing address:
  • Phone: 516-286-1188
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: MR. JONATHAN MAGRI
Title or Position: CEO/OWNER
Credential:
Phone: 516-286-1188