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General NPI Number Information
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NPI Number | 1942982244
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Entity Type | Organization
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Legal Business Name | NESHAMA PSYCHOLOGICAL SERVICES
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Dates
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Enumeration Date | 08/04/2023
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Last Update Date | 08/04/2023
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Provider Practice Location Address
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Address Line | 13037 235TH ST
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City | ROSEDALE
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State | NY
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Zip | 11422-1215
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Country | US
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Telephone | 646-209-3753
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Fax |
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Provider Business Mailing Address
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Address Line | 13037 235TH ST
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City | ROSEDALE
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State | NY
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Zip | 11422-1215
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Country | US
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Telephone | 646-209-3753
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Fax |
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | DR. DR. EARTHA M HACKETT
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Credential | PHD
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Telephone | 929-786-9552
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number |
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License Number State |
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