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General NPI Number Information
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NPI Number | 1225387772
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Entity Type | Organization
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Legal Business Name | MENTAL HEALTH ASSOCIATION OF NASSAU COUNTY
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Dates
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Enumeration Date | 08/30/2012
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Last Update Date | 08/30/2012
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Provider Practice Location Address
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Address Line | 21 THE TER
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City | PLANDOME
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State | NY
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Zip | 11030-1348
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Country | US
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Telephone | 516-365-1249
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Fax | 516-365-9799
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Provider Business Mailing Address
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Address Line | 16 MAIN ST
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City | HEMPSTEAD
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State | NY
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Zip | 11550-4020
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Country | US
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Telephone | 516-489-2322
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Fax | 516-489-2784
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | DAVID NEMIROFF
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Credential | LCSW
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Telephone | 516-489-2322
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 315P00000X
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Taxonomy Name | Intellectual Disabilities Intermediate Care Facility
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State | NY
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