Healthcare Provider Details

I. General information

NPI: 1275853764
Provider Name (Legal Business Name): HEATHER CUNHA AMATO PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/07/2010
Last Update Date: 11/02/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 MAMARONECK AVE STE 305
HARRISON NY
10528-1615
US

IV. Provider business mailing address

550 MAMARONECK AVE STE 305
HARRISON NY
10528-1615
US

V. Phone/Fax

Practice location:
  • Phone: 917-941-5353
  • Fax:
Mailing address:
  • Phone: 917-941-5353
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number003607-1
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number003607-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: