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General NPI Number Information
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NPI Number | 1205624608
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Entity Type | Organization
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Legal Business Name | MOHANNE LCSW PLLC
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Dates
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Enumeration Date | 04/28/2025
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Last Update Date | 12/29/2025
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Provider Practice Location Address
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Address Line | 516 LOCUST STREET APT 3D
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City | MT VERNON
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State | NY
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Zip | 10552
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Country | US
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Telephone | 917-599-3533
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Fax | 718-691-4968
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Provider Business Mailing Address
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Address Line | 21337 39TH AVE STE 308
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City | BAYSIDE
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State | NY
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Zip | 11361-2071
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Country | US
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Telephone | 917-599-3533
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Fax | 718-691-4968
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Authorized Official
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Title or Position | CE)/OWNER
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Name | MISS MOHANNE CHARLES
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Credential | LCSW
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Telephone | 917-599-3533
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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