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General NPI Number Information
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NPI Number | 1730532557
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Entity Type | Organization
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Legal Business Name | LIFE & LOSS MENTAL HEALTH COUNSELING, LLC
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Dates
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Enumeration Date | 07/16/2016
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Last Update Date | 07/16/2016
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Provider Practice Location Address
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Address Line | 200 W 57TH ST SUITE 1310
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City | NEW YORK
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State | NY
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Zip | 10019-3211
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Country | US
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Telephone | 212-204-6586
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Fax |
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Provider Business Mailing Address
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Address Line | 501 E 87TH ST APT 4F
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City | NEW YORK
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State | NY
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Zip | 10128-7608
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Country | US
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Telephone | 212-204-6586
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DIANE P BRENNAN
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Credential | LMHC
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Telephone | 212-204-6586
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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 | 005897
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License Number State | NY
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