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General NPI Number Information
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NPI Number | 1750103800
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Entity Type | Organization
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Legal Business Name | JASMINA MIMICA MENTAL HEALTH COUNSELING PLLC
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Dates
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Enumeration Date | 10/29/2024
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Last Update Date | 10/29/2024
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Provider Practice Location Address
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Address Line | 138 W 25TH ST
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City | NEW YORK
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State | NY
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Zip | 10001-7405
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Country | US
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Telephone | 646-655-9172
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Fax |
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Provider Business Mailing Address
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Address Line | 123 MELROSE ST APT 820
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City | BROOKLYN
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State | NY
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Zip | 11206-7885
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Country | US
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Telephone | 646-655-9172
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Fax |
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Authorized Official
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Title or Position | PRACTICE OWNER
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Name | JASMINA MIMICA
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Credential |
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Telephone | 917-941-2644
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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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