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General NPI Number Information
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NPI Number | 1194243345
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Entity Type | Individual
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Provider Name | KEREN ADAKI PSYD
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Gender | Female
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Dates
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Enumeration Date | 09/07/2017
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Last Update Date | 09/07/2017
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Provider Practice Location Address
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Address Line | 29 BARSTOW RD STE 201
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City | GREAT NECK
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State | NY
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Zip | 11021-2209
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Country | US
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Telephone | 917-526-0766
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Fax |
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Provider Business Mailing Address
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Address Line | 33 LEAHY AVE
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City | BRENTWOOD
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State | NY
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Zip | 11717-1011
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Country | US
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Telephone | 631-434-2545
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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 | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number |
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 003112
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License Number State | NY
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