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NPI Code Detail

MEDICARE: MRS. CHASITY ZAYAS-DOMINO MHC-LP

MEDICARE: MRS. CHASITY ZAYAS-DOMINO 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
1101YP2500XProfessional Counselor9063SC
2101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1891380572
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. CHASITY ZAYAS-DOMINO MHC-LP
Provider Business Mailing Address
First Line : 21 COMMACK RD
Second Line :
City : MASTIC BEACH
State : NY
Zip : 11951-3401
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4975 LACROSS RD STE 351
Second Line :
City : NORTH CHARLESTON
State : SC
Zip : 29406-6530
Country : US
Telephone Number : 855-284-7483
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/04/2021
Last Update Date : 12/12/2023

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