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General NPI Number Information
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NPI Number | 1184491250
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Entity Type | Organization
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Legal Business Name | ASPIRE MENTAL HEALTH COUNSELING P.C.
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Dates
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Enumeration Date | 12/07/2023
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Last Update Date | 12/07/2023
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Provider Practice Location Address
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Address Line | 2233 NESCONSET HWY STE 205
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City | LAKE GROVE
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State | NY
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Zip | 11755-1000
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Country | US
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Telephone | 631-521-9603
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Fax | 631-285-3660
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Provider Business Mailing Address
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Address Line | 2233 NESCONSET HWY STE 205
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City | LAKE GROVE
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State | NY
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Zip | 11755-1000
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Country | US
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Telephone | 631-521-9603
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Fax | 631-285-3660
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Authorized Official
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Title or Position | CEO/CLINICAL DIRECTOR
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Name | ANDREW HERBST
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Credential | LMHC
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Telephone | 631-521-9603
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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