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General NPI Number Information
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NPI Number | 1396205704
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Entity Type | Organization
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Legal Business Name | INTERSECTIONAL MENTAL HEALTH COUNSELING
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Dates
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Enumeration Date | 03/21/2019
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Last Update Date | 03/21/2019
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Provider Practice Location Address
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Address Line | 32 UNION SQ E STE 511
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City | NEW YORK
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State | NY
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Zip | 10003-3244
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Country | US
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Telephone | 917-410-1139
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Fax | 917-436-9799
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Provider Business Mailing Address
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Address Line | 3420 85TH ST
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City | JACKSON HEIGHTS
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State | NY
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Zip | 11372-3242
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Country | US
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Telephone | 845-661-9030
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | ALPANA CHOUDHURY
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Credential | LMHC
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Telephone | 917-410-1139
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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 |
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License Number State |
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