=====================================================
General NPI Number Information
=====================================================
NPI Number | 1720614985
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | VERANEST COUNSELING, PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/19/2020
-----------------------------------------------------
Last Update Date | 06/11/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1115 BROADWAY FL 10
-----------------------------------------------------
City | NEW YORK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10010-3454
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 917-204-9747
-----------------------------------------------------
Fax | 914-462-4476
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 540 W 53RD ST APT 6B
-----------------------------------------------------
City | NEW YORK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10019-5199
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 917-204-9747
-----------------------------------------------------
Fax | 914-462-4476
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNDER
-----------------------------------------------------
Name | GIOVANNA KAPSI
-----------------------------------------------------
Credential | LMCH, CASAC, MA
-----------------------------------------------------
Telephone | 917-204-9747
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------