Provider Demographics
NPI:1518769769
Name:BREAKING DAWN COUNSELING LCSW, PLLC
Entity type:Organization
Organization Name:BREAKING DAWN COUNSELING LCSW, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DRUSILLA
Authorized Official - Middle Name:
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:718-514-4615
Mailing Address - Street 1:365 BRONX RIVER RD APT 3F
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10704-3463
Mailing Address - Country:US
Mailing Address - Phone:718-514-4615
Mailing Address - Fax:
Practice Address - Street 1:365 BRONX RIVER RD APT 3F
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10704-3463
Practice Address - Country:US
Practice Address - Phone:718-514-4615
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-26
Last Update Date:2025-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)