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General NPI Number Information
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NPI Number | 1659640340
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Entity Type | Individual
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Provider Name | LOURDES IVETTE ROLON LMHC
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Gender | Female
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Dates
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Enumeration Date | 12/24/2011
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Last Update Date | 12/07/2025
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Provider Practice Location Address
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Address Line | 7410 35TH AVE SUITE 107 W
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City | JACKSON HEIGHTS
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State | NY
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Zip | 11372-8197
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Country | US
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Telephone | 718-672-1538
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Fax |
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Provider Business Mailing Address
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Address Line | 385 GRAND ST APT.# L705
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City | NEW YORK
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State | NY
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Zip | 10002-3968
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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 | 000742
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License Number State | NY
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