Healthcare Provider Details

I. General information

NPI: 1063259661
Provider Name (Legal Business Name): SHANIA ANGEL KAUR SEKHON MHC-LP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2024
Last Update Date: 07/10/2024
Certification Date: 06/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1216 BROADWAY
NEW YORK NY
10001-4483
US

IV. Provider business mailing address

235 E 40TH ST APT 28B
NEW YORK NY
10016-1753
US

V. Phone/Fax

Practice location:
  • Phone: 646-688-3540
  • Fax:
Mailing address:
  • Phone: 732-947-9769
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number18-P129473-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: