Healthcare Provider Details

I. General information

NPI: 1679919377
Provider Name (Legal Business Name): CHRIS LABBATE LMHC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/21/2013
Last Update Date: 05/21/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

144 MEMPHIS AVE
STATEN ISLAND NY
10312-3440
US

IV. Provider business mailing address

144 MEMPHIS AVE
STATEN ISLAND NY
10312-3440
US

V. Phone/Fax

Practice location:
  • Phone: 718-608-4780
  • Fax:
Mailing address:
  • Phone: 718-608-4780
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number005044
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: