Healthcare Provider Details

I. General information

NPI: 1447790233
Provider Name (Legal Business Name): TONI KUMAR LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/28/2017
Last Update Date: 05/14/2022
Certification Date: 05/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

939 JOHNSON AVE
RONKONKOMA NY
11779-6066
US

IV. Provider business mailing address

250 VETERANS MEMORIAL HWY RM 3A-12
HAUPPAUGE NY
11788-5500
US

V. Phone/Fax

Practice location:
  • Phone: 631-471-7242
  • Fax: 631-471-5150
Mailing address:
  • Phone: 631-952-6360
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number007773
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: