Healthcare Provider Details

I. General information

NPI: 1487578027
Provider Name (Legal Business Name): JEAN-MAX NAISSANT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/06/2026
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

232 N MAIN ST
SPRING VALLEY NY
10977-4020
US

IV. Provider business mailing address

11 NEW HEMPSTEAD RD FL 2
NEW CITY NY
10956-3664
US

V. Phone/Fax

Practice location:
  • Phone: 845-286-2210
  • Fax:
Mailing address:
  • Phone: 845-638-5909
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: