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General NPI Number Information
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NPI Number | 1275217614
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Entity Type | Organization
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Legal Business Name | INTAKE MENTAL HEALTH COUNSELING PLLC
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Dates
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Enumeration Date | 06/14/2023
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Last Update Date | 06/14/2023
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Provider Practice Location Address
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Address Line | 50 GLEN ST STE 232
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City | GLEN COVE
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State | NY
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Zip | 11542-4304
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Country | US
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Telephone | 516-234-6938
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Fax |
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Provider Business Mailing Address
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Address Line | 56 HENDRICK AVE
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City | GLEN COVE
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State | NY
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Zip | 11542-2938
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Country | US
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Telephone | 516-669-9188
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Fax |
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Authorized Official
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Title or Position | COUNSELOR
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Name | SANDY BAKER
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Credential | LMHC
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Telephone | 516-669-9188
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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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