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General NPI Number Information
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NPI Number | 1124744206
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Entity Type | Organization
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Legal Business Name | LIVE LOVE LOUD MENTAL HEALTH COUNSELING
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Dates
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Enumeration Date | 10/19/2022
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Last Update Date | 10/19/2022
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Provider Practice Location Address
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Address Line | 68 S SERVICE RD STE 100
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City | MELVILLE
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State | NY
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Zip | 11747-2350
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Country | US
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Telephone | 516-987-5122
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Fax | 516-269-7788
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Provider Business Mailing Address
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Address Line | 68 S SERVICE RD STE 100
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City | MELVILLE
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State | NY
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Zip | 11747-2350
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Country | US
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Telephone | 516-987-5122
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Fax | 516-269-7788
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Authorized Official
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Title or Position | CEO
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Name | STEPHANIE NICOLAS
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Credential |
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Telephone | 516-987-5122
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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 |
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License Number State |
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