MEDICARE: ASHLEY PICHARDO LMHC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	009644	NY

General Provider Information

NPI Number	:	1033667357
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHLEY PICHARDO LMHC

Provider Business Mailing Address
First Line	:	4470 21ST ST
Second Line	:
City	:	LONG ISLAND CITY
State	:	NY
Zip	:	11101-5114
Country	:	US
Telephone Number	:	917-522-1418
Fax Number	:

Provider Business Practice Location Address
First Line	:	4470 21ST ST
Second Line	:
City	:	LONG ISLAND CITY
State	:	NY
Zip	:	11101-5114
Country	:	US
Telephone Number	:	917-522-1418
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/15/2016
Last Update Date	:	06/10/2021

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