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General NPI Number Information
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NPI Number | 1003337171
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Entity Type | Individual
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Provider Name | SHANA MARIE ARMSTRONG
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Gender | Female
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Dates
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Enumeration Date | 06/29/2017
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Last Update Date | 06/29/2017
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Provider Practice Location Address
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Address Line | 872 MIDDLE COUNTRY RD
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City | SAINT JAMES
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State | NY
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Zip | 11780-3223
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Country | US
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Telephone | 631-758-8290
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Fax |
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Provider Business Mailing Address
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Address Line | 49 OLD FIELD RD
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City | SETAUKET
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State | NY
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Zip | 11733-1610
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Country | US
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Telephone | 631-742-9619
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | P06599
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License Number State | NY
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