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General NPI Number Information
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NPI Number | 1255098364
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Entity Type | Organization
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Legal Business Name | MIND BODY AND SOUL COUNSELING LLC
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Dates
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Enumeration Date | 11/23/2021
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Last Update Date | 05/25/2022
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Provider Practice Location Address
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Address Line | 19 VALENTINE AVE
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City | HUNTINGTON
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State | NY
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Zip | 11743-4952
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Country | US
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Telephone | 516-581-4242
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Fax |
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Provider Business Mailing Address
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Address Line | 90 ADAMS AVE
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City | HAUPPAUGE
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State | NY
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Zip | 11788-3631
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Country | US
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Telephone | 631-885-8990
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Fax | 631-935-0006
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Authorized Official
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Title or Position | OWNER
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Name | ALLISON SPINNER
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Credential | LMHC
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Telephone | 516-581-4242
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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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