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General NPI Number Information
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NPI Number | 1346223252
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Entity Type | Organization
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Legal Business Name | HEART & SOUL COMMUNITY COUNSELING
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Dates
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Enumeration Date | 11/23/2005
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Last Update Date | 05/08/2019
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Provider Practice Location Address
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Address Line | 17 FORDHAM RD
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City | WEST BABYLON
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State | NY
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Zip | 11704-5803
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Country | US
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Telephone | 631-321-7011
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Fax | 631-669-8532
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Provider Business Mailing Address
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Address Line | 17 FORDHAM RD
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City | WEST BABYLON
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State | NY
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Zip | 11704-5803
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Country | US
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Telephone | 631-321-7011
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Fax | 631-669-8532
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Authorized Official
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Title or Position | PRESIDENT / EXECUTIVE DIRECTOR
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Name | TINA L CALABRESE
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Credential |
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Telephone | 631-321-7011
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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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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