Healthcare Provider Details

I. General information

NPI: 1497686190
Provider Name (Legal Business Name): TZANIS MENTAL HEALTH COUNSELING, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/29/2026
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

417 MAIN ST STE D
ISLIP NY
11751-3552
US

IV. Provider business mailing address

78 SUGAR MAPLE RD
LEVITTOWN NY
11756-2239
US

V. Phone/Fax

Practice location:
  • Phone: 516-784-7359
  • Fax:
Mailing address:
  • Phone: 516-784-7359
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: DIMITRA TZANIS
Title or Position: DIRECTOR
Credential: MS, LMHC-D, NCC
Phone: 516-784-7359