Healthcare Provider Details

I. General information

NPI: 1982419347
Provider Name (Legal Business Name): HERIBERTO ECHEVARRIA JR. HEALTH EDUCATOR
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: HERIBERTO ECHEVARRIA JR. CHES

II. Dates (important events)

Enumeration Date: 02/11/2025
Last Update Date: 09/07/2026
Certification Date: 09/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

64 11TH AVE
HUNTINGTON STATION NY
11746-2226
US

IV. Provider business mailing address

64 11TH AVE
HUNTINGTON STATION NY
11746-2226
US

V. Phone/Fax

Practice location:
  • Phone: 929-491-9962
  • Fax:
Mailing address:
  • Phone: 929-491-9962
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171W00000X
TaxonomyContractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 7
Primary TaxonomyN
Taxonomy Code172A00000X
TaxonomyDriver
License Number
License Number State
# 8
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: