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General NPI Number Information
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NPI Number | 1972171775
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Entity Type | Organization
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Legal Business Name | MICHELLE VALDNER MENTAL HEALTH COUNSELING PLLC
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Dates
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Enumeration Date | 06/16/2021
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Last Update Date | 10/23/2024
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Provider Practice Location Address
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Address Line | 3650 LONG BEACH RD STE 1022
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City | OCEANSIDE
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State | NY
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Zip | 11572-5705
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Country | US
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Telephone | 516-500-7591
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Fax |
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Provider Business Mailing Address
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Address Line | 17 3RD AVE
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City | GARDEN CITY PARK
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State | NY
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Zip | 11040-5021
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Country | US
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Telephone | 516-503-0628
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Fax |
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Authorized Official
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Title or Position | SOLE MEMBER
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Name | MICHELLE COLLURA
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Credential |
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Telephone | 516-500-7591
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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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