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NPI 1366010704

NPI 1366010704 : ELZINETTE T. WHEELER LMHC : HICKSVILLE, NY

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General NPI Number Information
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    NPI Number           |    1366010704
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    Entity Type          |    Individual 
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    Provider Name        |    ELZINETTE T. WHEELER LMHC
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    06/13/2021
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    Last Update Date     |    06/13/2021
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Provider Practice Location Address
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    Address Line         |    28 E OLD COUNTRY RD UNIT 2 
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    City                 |    HICKSVILLE
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    State                |    NY
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    Zip                  |    11801-4292
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    Country              |    US
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    Telephone            |    917-485-3584
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    842 DUNCAN DR 
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    City                 |    WESTBURY
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    State                |    NY
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    Zip                  |    11590-1405
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    Country              |    US
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    Telephone            |    917-485-3584
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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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       |    010935-01
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    License Number State |    NY
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