Healthcare Provider Details

I. General information

NPI: 1255246526
Provider Name (Legal Business Name): RAQUEL ALEXIS OREJUELA LMHC-D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2026
Last Update Date: 08/19/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5927 MASPETH AVE
MASPETH NY
11378-2709
US

IV. Provider business mailing address

5927 MASPETH AVE
MASPETH NY
11378-2709
US

V. Phone/Fax

Practice location:
  • Phone: 347-740-3734
  • Fax:
Mailing address:
  • Phone: 347-740-3734
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number015792
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: