Healthcare Provider Details

I. General information

NPI: 1447997796
Provider Name (Legal Business Name): KOFMAN MENTAL HEALTH COUNSELING, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2022
Last Update Date: 05/18/2022
Certification Date: 05/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

961 BROADWAY STE 102
WOODMERE NY
11598-1733
US

IV. Provider business mailing address

961 BROADWAY STE 102
WOODMERE NY
11598-1733
US

V. Phone/Fax

Practice location:
  • Phone: 917-524-7663
  • Fax:
Mailing address:
  • Phone:
  • Fax:

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: YANA KOFMAN
Title or Position: FOUNDER
Credential: LMHC
Phone: 646-797-1648