Healthcare Provider Details

I. General information

NPI: 1295561660
Provider Name (Legal Business Name): FRANKLIN MEJIA LMHC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/11/2024
Last Update Date: 09/11/2024
Certification Date: 09/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 ACADEMY ST APT 14G
NEW YORK NY
10034-5220
US

IV. Provider business mailing address

550 ACADEMY ST APT 14G
NEW YORK NY
10034-5220
US

V. Phone/Fax

Practice location:
  • Phone: 646-875-3461
  • Fax:
Mailing address:
  • Phone: 646-875-3461
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number015038
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: