Provider Demographics
NPI:1245645126
Name:LONG ISLAND MENTAL HEALTH WELLNESS COUNSELING PLLC
Entity type:Organization
Organization Name:LONG ISLAND MENTAL HEALTH WELLNESS COUNSELING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER, DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MEGAN
Authorized Official - Middle Name:N
Authorized Official - Last Name:WOODWARD
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LMHC, MBA, NCC
Authorized Official - Phone:516-506-0836
Mailing Address - Street 1:293 CASTLE AVE STE 2F
Mailing Address - Street 2:
Mailing Address - City:WESTBURY
Mailing Address - State:NY
Mailing Address - Zip Code:11590-2025
Mailing Address - Country:US
Mailing Address - Phone:516-506-0836
Mailing Address - Fax:516-506-0834
Practice Address - Street 1:293 CASTLE AVE STE 2F
Practice Address - Street 2:
Practice Address - City:WESTBURY
Practice Address - State:NY
Practice Address - Zip Code:11590-2025
Practice Address - Country:US
Practice Address - Phone:516-506-0836
Practice Address - Fax:516-506-0834
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-30
Last Update Date:2014-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005680101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty