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General NPI Number Information
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NPI Number | 1124733290
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Entity Type | Organization
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Legal Business Name | REFLECTIONS THERAPY LCSW PC
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Dates
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Enumeration Date | 01/23/2023
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Last Update Date | 01/23/2023
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Provider Practice Location Address
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Address Line | 315 WALT WHITMAN RD STE 209
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City | HUNTINGTON STATION
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State | NY
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Zip | 11746-4112
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Country | US
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Telephone | 516-508-3579
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Fax |
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Provider Business Mailing Address
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Address Line | 59 S GRAND ST
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City | WESTBURY
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State | NY
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Zip | 11590-4344
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Country | US
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Telephone | 631-871-1388
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Fax |
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Authorized Official
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Title or Position | CEO/OWNER
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Name | HEATHER MARIE GILLIGAN
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Credential | LCSW, PMH-C
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Telephone | 631-871-1388
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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