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General NPI Number Information
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NPI Number | 1114390069
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Entity Type | Organization
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Legal Business Name | DEJEN ASSOCIATES, INC.
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Dates
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Enumeration Date | 10/31/2015
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Last Update Date | 10/31/2015
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Provider Practice Location Address
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Address Line | 925 BERGEN ST 403
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City | BROOKLYN
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State | NY
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Zip | 11238-3367
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Country | US
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Telephone | 646-503-5457
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Fax |
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Provider Business Mailing Address
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Address Line | 925 BERGEN ST 403
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City | BROOKLYN
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State | NY
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Zip | 11238-3367
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. CHARMAINE LYISCOTT
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Credential | LMHC
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Telephone | 646-503-5457
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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 | 18003661
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License Number State | NY
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