Healthcare Provider Details

I. General information

NPI: 1487588760
Provider Name (Legal Business Name): AURORA PSYCHOTHERAPY LMHC PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/11/2026
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25522 148TH DR FL 2
ROSEDALE NY
11422-2806
US

IV. Provider business mailing address

303 5TH AVE RM 1703
NEW YORK NY
10016-6641
US

V. Phone/Fax

Practice location:
  • Phone: 917-979-8263
  • Fax: 646-809-8516
Mailing address:
  • Phone: 917-979-8263
  • Fax: 646-809-8516

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: NIESA ANA MARIA WHITE
Title or Position: OWNER
Credential: LMHC
Phone: 718-962-5701