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General NPI Number Information
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NPI Number | 1720756562
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Entity Type | Organization
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Legal Business Name | NEAS MINDFULNESS THERAPY LCSW,PLLC
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Dates
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Enumeration Date | 09/04/2021
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Last Update Date | 05/01/2023
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Provider Practice Location Address
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Address Line | 3 E EVERGREEN RD # 1191
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City | NEW CITY
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State | NY
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Zip | 10956-5145
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Country | US
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Telephone | 914-269-8019
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Fax |
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Provider Business Mailing Address
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Address Line | 3 E EVERGREEN RD # 1191
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City | NEW CITY
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State | NY
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Zip | 10956-5145
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Country | US
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Telephone | 914-269-8019
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | LUCKDJYNE NEAS
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Credential | LCSW
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Telephone | 914-269-8019
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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