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General NPI Number Information
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NPI Number | 1477432656
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Entity Type | Organization
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Legal Business Name | A PLACE FOR YOU MENTAL HEALTH COUNSELING, P.C
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Dates
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Enumeration Date | 09/01/2025
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Last Update Date | 09/01/2025
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Provider Practice Location Address
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Address Line | 3930 RICHMOND AVE STE 4
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City | STATEN ISLAND
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State | NY
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Zip | 10312-5104
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Country | US
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Telephone | 718-974-2757
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Fax |
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Provider Business Mailing Address
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Address Line | 41 ANNAPOLIS DR
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City | HAZLET
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State | NJ
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Zip | 07730-2301
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Country | US
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Telephone | 718-974-2757
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Fax |
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | JACQUELINE IMBEMBA
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Credential | LMHC, LPC
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Telephone | 718-974-2757
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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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