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NPI 1700740420

NPI 1700740420 : KIZZY DINELLE SPRINGER : RIDGEWOOD, NY

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General NPI Number Information
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    NPI Number           |    1700740420
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    Entity Type          |    Individual 
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    Provider Name        |    KIZZY DINELLE SPRINGER
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    12/16/2025
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    Last Update Date     |    12/16/2025
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Provider Practice Location Address
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    Address Line         |    1614 WEIRFIELD ST 
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    City                 |    RIDGEWOOD
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    State                |    NY
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    Zip                  |    11385-5350
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    Country              |    US
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    Telephone            |    718-456-7820
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    8620 208TH ST 
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    City                 |    QUEENS VILLAGE
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    State                |    NY
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    Zip                  |    11427-1682
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    Country              |    US
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    Telephone            |    718-456-7820
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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       |    014426
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    License Number State |    NY
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