Healthcare Provider Details

I. General information

NPI: 1205615374
Provider Name (Legal Business Name): ABBY R SPILKA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/27/2023
Last Update Date: 09/27/2023
Certification Date: 09/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

159 BLEECKER ST APT 2C
NEW YORK NY
10012-1490
US

IV. Provider business mailing address

338 15TH ST APT 2
BROOKLYN NY
11215-7114
US

V. Phone/Fax

Practice location:
  • Phone: 646-598-9767
  • Fax:
Mailing address:
  • Phone: 917-902-9811
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: RACHEL ABBY SPILKA
Title or Position: COUNSELOR
Credential: LMHC
Phone: 646-598-9767