=====================================================
General NPI Number Information
=====================================================
NPI Number | 1316818495
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | JULIA KEFFER LICENSED MENTAL HEALTH COUNSELOR PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/13/2025
-----------------------------------------------------
Last Update Date | 09/13/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 185 SOUTH ST FL 2
-----------------------------------------------------
City | OYSTER BAY
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11771-2254
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 516-318-8057
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 52 HIGHWOOD RD
-----------------------------------------------------
City | OYSTER BAY
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11771-3802
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | JULIA KEFFER
-----------------------------------------------------
Credential | LMHC-D
-----------------------------------------------------
Telephone | 516-318-8057
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------