MEDICARE: CELINE A DU TERTRE D'ELMARCQ 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
1	101YM0800X	Mental Health Counselor	016934	NY

General Provider Information

NPI Number	:	1952140055
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CELINE A DU TERTRE D'ELMARCQ LMHC

Provider Business Mailing Address
First Line	:	134 BROADWAY
Second Line	:	FL 4, STE 3
City	:	BROOKLYN
State	:	NY
Zip	:	11249-6233
Country	:	US
Telephone Number	:	201-357-0235
Fax Number	:	929-392-1391

Provider Business Practice Location Address
First Line	:	134 BROADWAY
Second Line	:	FL 4, STE 3
City	:	BROOKLYN
State	:	NY
Zip	:	11249-6233
Country	:	US
Telephone Number	:	201-357-0235
Fax Number	:	929-392-1391

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

Provider Enumeration Date	:	05/20/2024
Last Update Date	:	12/23/2025

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