MEDICARE: ALEXA FERST 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
1	101YM0800X	Mental Health Counselor	P133904	NY

General Provider Information

NPI Number	:	1548075286
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEXA FERST MHC-LP

Provider Business Mailing Address
First Line	:	145 LINCOLN RD
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11225-4079
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	50 E 42ND ST RM 503
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10017-5436
Country	:	US
Telephone Number	:	917-310-5940
Fax Number	:

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

Provider Enumeration Date	:	02/10/2025
Last Update Date	:	02/10/2025

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