Healthcare Provider Details

I. General information

NPI: 1982157152
Provider Name (Legal Business Name): MRS. CARLINA LEON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/25/2016
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

80 5TH AVE RM 903
NEW YORK NY
10011-7611
US

IV. Provider business mailing address

80 5TH AVE RM 903
NEW YORK NY
10011-7611
US

V. Phone/Fax

Practice location:
  • Phone: 212-683-7327
  • Fax: 212-683-7327
Mailing address:
  • Phone: 212-683-7327
  • Fax: 212-683-7327

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number009333
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number46.004882
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: