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General NPI Number Information
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NPI Number | 1447008628
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Entity Type | Organization
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Legal Business Name | HEALTHY SELF MENTAL HEALTH COUNSELING SERVICES PLLC
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Dates
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Enumeration Date | 05/11/2024
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Last Update Date | 10/09/2024
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Provider Practice Location Address
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Address Line | 240 MADISON AVE # 10L
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City | NEW YORK
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State | NY
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Zip | 10016-2820
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Country | US
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Telephone | 516-342-0481
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Fax |
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Provider Business Mailing Address
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Address Line | 96 TAYLOR AVE
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City | ROOSEVELT
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State | NY
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Zip | 11575-2023
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Country | US
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Telephone | 516-342-0481
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | PALAK AGRAWAL
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Credential | LMHC
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Telephone | 516-342-0481
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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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 |
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License Number State |
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