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NPI Code Detail

MEDICARE: LAMISA RAB MHC-LP

MEDICARE:   LAMISA  RAB  MHC-LP
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
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1164141081
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAMISA RAB MHC-LP
Provider Business Mailing Address
First Line : 6475 AUSTIN ST APT 3C
Second Line :
City : REGO PARK
State : NY
Zip : 11374-4194
Country : US
Telephone Number : 408-599-6065
Fax Number :
Provider Business Practice Location Address
First Line : 2545 SEDGWICK AVE
Second Line :
City : BRONX
State : NY
Zip : 10468-3802
Country : US
Telephone Number : 718-926-9975
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/24/2022
Last Update Date : 06/04/2025

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