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General NPI Number Information
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NPI Number | 1518363936
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Entity Type | Organization
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Legal Business Name | CHAVONE LORRAINE CRESPO
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Dates
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Enumeration Date | 11/12/2014
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Last Update Date | 11/12/2014
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Provider Practice Location Address
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Address Line | 211 E 43RD ST SUITE 1101
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City | NEW YORK
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State | NY
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Zip | 10017-4707
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Country | US
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Telephone | 212-368-6759
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Fax | 212-682-3952
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Provider Business Mailing Address
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Address Line | 211 E 43RD ST SUITE 1101
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City | NEW YORK
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State | NY
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Zip | 10017-4707
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Country | US
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Telephone | 212-368-6759
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Fax | 212-682-3952
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Authorized Official
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Title or Position | MENTAL HEALTH COUNSELOR
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Name | CHAVONE LORRAINE CRESPO
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Credential | MHC
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Telephone | 212-368-6759
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | P92787
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License Number State | NY
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