Healthcare Provider Details

I. General information

NPI: 1992967848
Provider Name (Legal Business Name): JOANNA KABAT-REY LMHC LCAT CASAC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/01/2008
Last Update Date: 02/07/2024
Certification Date: 02/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11525 84TH AVE APT 4H
RICHMOND HILL NY
11418-1413
US

IV. Provider business mailing address

11525 84TH AVE APT 4H
RICHMOND HILL NY
11418-1413
US

V. Phone/Fax

Practice location:
  • Phone: 718-459-0472
  • Fax:
Mailing address:
  • Phone: 718-459-0472
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number17487
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number002205
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: