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General NPI Number Information
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NPI Number | 1962982173
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Entity Type | Organization
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Legal Business Name | THERAPY BROOKLYN MENTAL HEALTH COUNSELING PLLC
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Dates
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Enumeration Date | 08/16/2018
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Last Update Date | 01/11/2022
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Provider Practice Location Address
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Address Line | 67 WEST ST STE 401
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City | BROOKLYN
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State | NY
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Zip | 11222-5391
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Country | US
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Telephone | 347-752-1259
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Fax |
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Provider Business Mailing Address
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Address Line | 67 WEST ST STE 401
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City | BROOKLYN
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State | NY
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Zip | 11222-5391
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Country | US
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Telephone | 347-752-1259
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Fax |
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Authorized Official
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Title or Position | LICENSED MENTAL HEALTH COUNSELOR
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Name | MARISSA MOORE
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Credential |
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Telephone | 917-376-3564
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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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