Healthcare Provider Details

I. General information

NPI: 1992262034
Provider Name (Legal Business Name): ELEANOR HAMLIN LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/25/2019
Last Update Date: 05/09/2023
Certification Date: 05/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

98-120 QUEENS BLVD
REGO PARK NY
11374-2321
US

IV. Provider business mailing address

98-120 QUEENS BLVD
REGO PARK NY
11374-2321
US

V. Phone/Fax

Practice location:
  • Phone: 718-830-0246
  • Fax:
Mailing address:
  • Phone: 718-830-0246
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number012679
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: