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NPI Code Detail

MEDICARE: NASSAU COUNTY MARRIAGE AND FAMILY THERAPY GROUP, PLLC

MEDICARE: NASSAU COUNTY MARRIAGE AND FAMILY THERAPY GROUP, PLLC
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
1106H00000XMarriage & Family Therapist

General Provider Information

NPI Number : 1164260824
Entity Type Code : Organization
Provider Name (Legal Business Name) : NASSAU COUNTY MARRIAGE AND FAMILY THERAPY GROUP, PLLC
Provider Business Mailing Address
First Line : 46 SHERBROOKE DR
Second Line :
City : SMITHTOWN
State : NY
Zip : 11787-4704
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 64 BROADWAY
Second Line :
City : AMITYVILLE
State : NY
Zip : 11701-2702
Country : US
Telephone Number : 718-510-2170
Fax Number :
Authorized Official
Title or Position : CO-OWNER/CEO
Name : MICHELLE ECKHOFF
Credential : LMFT
Telephone Number : 718-510-2170
Provider Enumeration Date : 07/17/2024
Last Update Date : 07/17/2024

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Directions to “NASSAU COUNTY MARRIAGE AND FAMILY THERAPY GROUP, PLLC ” Practice Location

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