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General NPI Number Information
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NPI Number | 1801443312
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Entity Type | Organization
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Legal Business Name | CARLINA LEON LLC
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Dates
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Enumeration Date | 08/20/2019
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Last Update Date | 10/25/2024
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Provider Practice Location Address
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Address Line | 602 W 146TH ST APT 22
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City | NEW YORK
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State | NY
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Zip | 10031-4309
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Country | US
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Telephone | 212-683-7327
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Fax |
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Provider Business Mailing Address
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Address Line | 80 5TH AVE RM 903
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City | NEW YORK
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State | NY
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Zip | 10011-7611
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Country | US
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Telephone | 212-683-7327
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | CARLINA DESIREE LEON
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Credential | LMHC, NCC
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Telephone | 917-910-8474
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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