Provider Demographics
NPI:1356931422
Name:MI ALEGRIA PSYCHOTHERAPY LCSW PLLC
Entity type:Organization
Organization Name:MI ALEGRIA PSYCHOTHERAPY LCSW PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DIANA
Authorized Official - Middle Name:MARIA
Authorized Official - Last Name:GONZALES-RICARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:914-362-9040
Mailing Address - Street 1:2125 ALBANY POST RD # 305
Mailing Address - Street 2:
Mailing Address - City:MONTROSE
Mailing Address - State:NY
Mailing Address - Zip Code:10548-1447
Mailing Address - Country:US
Mailing Address - Phone:914-362-9040
Mailing Address - Fax:914-373-2366
Practice Address - Street 1:2125 ALBANY POST RD # 305
Practice Address - Street 2:
Practice Address - City:MONTROSE
Practice Address - State:NY
Practice Address - Zip Code:10548-1447
Practice Address - Country:US
Practice Address - Phone:914-362-9040
Practice Address - Fax:914-373-2366
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-22
Last Update Date:2021-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health