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NPI Code Detail

MEDICARE: REBECCA JEAN PEART LMHC

MEDICARE: REBECCA JEAN PEART 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 Counselor008748NY

General Provider Information

NPI Number : 1740840891
Entity Type Code : Individual
Provider Name (Legal Business Name) : REBECCA JEAN PEART LMHC
Provider Business Mailing Address
First Line : 301 N UTICA AVE
Second Line :
City : MASSAPEQUA
State : NY
Zip : 11758-2149
Country : US
Telephone Number : 516-512-2498
Fax Number :
Provider Business Practice Location Address
First Line : 110 E 60TH ST RM 704
Second Line :
City : NEW YORK
State : NY
Zip : 10022-1799
Country : US
Telephone Number : 845-279-5908
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/19/2019
Last Update Date : 09/12/2023

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Directions to “ REBECCA JEAN PEART LMHC” Practice Location

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