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General NPI Number Information
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NPI Number | 1356475107
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Entity Type | Organization
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Legal Business Name | MOUNTAINVIEW COUNSELING AND PSYCHOLOGICAL SERVICES, PC
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Dates
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Enumeration Date | 03/15/2007
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Last Update Date | 09/28/2007
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Provider Practice Location Address
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Address Line | 4250 VETERANS MEMORIAL HWY SUITE 215 EAST
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City | HOLBROOK
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State | NY
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Zip | 11741-4000
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Country | US
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Telephone | 631-981-5762
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Fax | 631-981-5762
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Provider Business Mailing Address
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Address Line | 4250 VETERANS MEMORIAL HWY SUITE 215 EAST
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City | HOLBROOK
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State | NY
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Zip | 11741-4000
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Country | US
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Telephone | 631-981-5762
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Fax | 631-981-5762
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Authorized Official
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Title or Position | PSYCHOLOGIST
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Name | DR. KIM HESCHELES
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Credential |
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Telephone | 631-981-5762
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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