Healthcare Provider Details

I. General information

NPI: 1417594680
Provider Name (Legal Business Name): COUNSELING FOR YOU LONG ISLAND
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2019
Last Update Date: 06/27/2022
Certification Date: 06/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1757 MERRICK AVE STE 106
MERRICK NY
11566-2717
US

IV. Provider business mailing address

1757 MERRICK AVE STE 106
MERRICK NY
11566-2717
US

V. Phone/Fax

Practice location:
  • Phone: 516-247-6449
  • Fax: 516-407-2898
Mailing address:
  • Phone: 516-247-6449
  • Fax: 516-407-2898

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: CRISTINA MURPHY
Title or Position: PRESIDENT
Credential: LMHC
Phone: 516-247-6449