MEDICARE: ASIYAH FARHANE 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	017302	NY

General Provider Information

NPI Number	:	1821859737
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASIYAH FARHANE MHC-LP

Provider Business Mailing Address
First Line	:	395 ANN ST # 1L
Second Line	:
City	:	NEWBURGH
State	:	NY
Zip	:	12550-5335
Country	:	US
Telephone Number	:	347-740-8403
Fax Number	:

Provider Business Practice Location Address
First Line	:	1284 E 19TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11230-5404
Country	:	US
Telephone Number	:	929-552-5134
Fax Number	:

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

Provider Enumeration Date	:	01/17/2024
Last Update Date	:	05/29/2026

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