Healthcare Provider Details

I. General information

NPI: 1003738691
Provider Name (Legal Business Name): KATHLEEN MENEGOZZI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/27/2026
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

330 W 58TH ST STE 305
NEW YORK NY
10019-1801
US

IV. Provider business mailing address

50 CLINTON PL UNIT 1405
NEW ROCHELLE NY
10801-6442
US

V. Phone/Fax

Practice location:
  • Phone: 929-352-5695
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number013837
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: