Healthcare Provider Details

I. General information

NPI: 1699483826
Provider Name (Legal Business Name): EUNICE ESCUDERO LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/07/2022
Last Update Date: 07/17/2025
Certification Date: 07/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 CROSFIELD AVE STE 104
WEST NYACK NY
10994-2229
US

IV. Provider business mailing address

1 CROSFIELD AVE STE 104
WEST NYACK NY
10994-2229
US

V. Phone/Fax

Practice location:
  • Phone: 845-279-5908
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number00175501
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number001755
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: