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General NPI Number Information
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NPI Number | 1639933344
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Entity Type | Individual
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Provider Name | MORGAN NAZARZADEH
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Gender | Female
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Dates
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Enumeration Date | 02/13/2024
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Last Update Date | 04/19/2024
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Provider Practice Location Address
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Address Line | 2 KINGS TERRACE RD
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City | GREAT NECK
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State | NY
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Zip | 11024-1425
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Country | US
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Telephone | 516-661-4782
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Fax |
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Provider Business Mailing Address
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Address Line | 60 W 23RD ST APT 840
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City | NEW YORK
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State | NY
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Zip | 10010-5293
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 011934
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License Number State | NY
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