MEDICARE: REBECCA KANGWA MENTAL HEALTH COUNSELING

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

General Provider Information

NPI Number	:	1508657859
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REBECCA KANGWA MENTAL HEALTH COUNSELING

Provider Business Mailing Address
First Line	:	276 5TH AVE RM 704
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10001-4527
Country	:	US
Telephone Number	:	607-414-2003
Fax Number	:

Provider Business Practice Location Address
First Line	:	2375 CRESCENT ST # 2
Second Line	:
City	:	ASTORIA
State	:	NY
Zip	:	11105-3107
Country	:	US
Telephone Number	:	607-414-2003
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	REBECCA KANGWA
Credential	:	LMHC
Telephone Number	:	607-414-2003

Provider Enumeration Date	:	05/15/2025
Last Update Date	:	05/15/2025

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