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General NPI Number Information
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NPI Number | 1710579511
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Entity Type | Organization
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Legal Business Name | GUIDED EPIPHANY INCORPORATED
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Dates
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Enumeration Date | 02/03/2021
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Last Update Date | 08/24/2023
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Provider Practice Location Address
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Address Line | 352 7TH AVENUE 12TH FLOOR
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City | NEW YORK
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State | NY
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Zip | 10001-5012
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Country | US
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Telephone | 917-300-8645
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Fax |
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Provider Business Mailing Address
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Address Line | 1960 EAST TREMONT AVENUE #1H
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City | BRONX
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State | NY
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Zip | 10462-5641
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Country | US
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Telephone | 917-300-8645
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Fax |
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Authorized Official
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Title or Position | OWNER/LICENSED MENTAL HEALTH COUNSE
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Name | MS. CRYSTAL DANIELS
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Credential | LMHC
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Telephone | 917-300-8645
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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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