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General NPI Number Information
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NPI Number | 1376966036
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Entity Type | Individual
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Provider Name | CRISTINA MELISSA KONIOR LMHC, CASAC
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Gender | Female
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Dates
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Enumeration Date | 01/30/2014
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Last Update Date | 03/26/2018
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Provider Practice Location Address
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Address Line | 19 W 34TH ST PH
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City | NEW YORK
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State | NY
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Zip | 10001-3006
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Country | US
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Telephone | 646-504-6882
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Fax |
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Provider Business Mailing Address
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Address Line | 332 E 71ST ST APT 5B
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City | NEW YORK
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State | NY
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Zip | 10021-5295
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Country | US
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Telephone | 845-558-6651
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 24200
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 005355
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License Number State | NY
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