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NPI 1740604271

NPI 1740604271 : JOHAN ENRIQUE MEJIA LCSW : WEST HEMPSTEAD, NY

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General NPI Number Information
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    NPI Number           |    1740604271
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    Entity Type          |    Individual 
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    Provider Name        |    JOHAN ENRIQUE MEJIA LCSW
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    02/04/2014
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    Last Update Date     |    11/15/2025
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Provider Practice Location Address
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    Address Line         |    600 HEMPSTEAD TPKE 
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    City                 |    WEST HEMPSTEAD
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    State                |    NY
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    Zip                  |    11552-1095
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    Country              |    US
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    Telephone            |    516-481-2890
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    184 SPRUCEWOOD DR 
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    City                 |    LEVITTOWN
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    State                |    NY
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    Zip                  |    11756-3838
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    Country              |    US
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    Telephone            |    917-977-1104
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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        |    1041C0700X
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    Taxonomy Name        |    Clinical Social Worker
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    License Number       |    089701
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    License Number State |    NY
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