Healthcare Provider Details

I. General information

NPI: 1093383481
Provider Name (Legal Business Name): STEFANYA CAUSEY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/14/2021
Last Update Date: 06/14/2021
Certification Date: 06/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

136 MADISON AVE FL 6
NEW YORK NY
10016-6795
US

IV. Provider business mailing address

210 W 16TH ST APT 3I
NEW YORK NY
10011-6133
US

V. Phone/Fax

Practice location:
  • Phone: 619-654-4037
  • 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:
Title or Position:
Credential:
Phone: