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General NPI Number Information
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NPI Number | 1407233786
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Entity Type | Organization
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Legal Business Name | EKM PSYCHOLOGICAL COUNSELING LLC
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Dates
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Enumeration Date | 05/06/2015
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Last Update Date | 05/06/2015
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Provider Practice Location Address
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Address Line | 140 W 71ST ST APT 1C
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City | NEW YORK
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State | NY
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Zip | 10023-4021
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Country | US
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Telephone | 917-602-2186
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Fax |
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Provider Business Mailing Address
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Address Line | 79 COOPER LN
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City | LARCHMONT
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State | NY
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Zip | 10538-1802
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Country | US
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Telephone | 917-602-2186
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Fax |
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Authorized Official
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Title or Position | PSYCHOLOGIST
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Name | ERICA MACGREGOR
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Credential | PHD
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Telephone | 917-602-2186
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number | 018533
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License Number State | NY
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