Healthcare Provider Details

I. General information

NPI: 1659252773
Provider Name (Legal Business Name): PEACE LOVE WELLNESS MENTAL HEALTH COUNSELING PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/08/2025
Last Update Date: 09/08/2025
Certification Date: 08/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

141 W 28TH ST SUITE 301
NEW YORK NY
10001
US

IV. Provider business mailing address

41 SCHERMERHORN ST # 1016
BROOKLYN NY
11201-4802
US

V. Phone/Fax

Practice location:
  • Phone: 212-466-6009
  • Fax:
Mailing address:
  • Phone: 212-466-6009
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: CAMERON AFSHARI ESHGH
Title or Position: OWNER
Credential: LMHC, LMSW
Phone: 212-466-6009