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NPI Code Detail

MEDICARE: MR. IOANIS PAPAVASSILIU M.A., LMHC

MEDICARE: MR. IOANIS PAPAVASSILIU M.A., 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
1101YM0800XMental Health Counselor17771NY

General Provider Information

NPI Number : 1407066251
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. IOANIS PAPAVASSILIU M.A., LMHC
Provider Business Mailing Address
First Line : 374 12TH ST APT 2
Second Line :
City : BROOKLYN
State : NY
Zip : 11215-5002
Country : US
Telephone Number : 718-832-1126
Fax Number :
Provider Business Practice Location Address
First Line : 300 FLATBUSH AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11217-2812
Country : US
Telephone Number : 718-622-2000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/23/2007
Last Update Date : 07/08/2007

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