Healthcare Provider Details

I. General information

NPI: 1295689107
Provider Name (Legal Business Name): DEAR SELF MENTAL HEALTH COUNSELING PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/26/2026
Last Update Date: 02/26/2026
Certification Date: 02/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

531 50TH AVE
LONG ISLAND CITY NY
11101-6297
US

IV. Provider business mailing address

4501 39TH AVE APT 425
SUNNYSIDE NY
11104
US

V. Phone/Fax

Practice location:
  • Phone: 347-270-7763
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: DIANA IOANA MICHELENA
Title or Position: OWNER
Credential: LMHC-D
Phone: 347-270-7763