Provider Demographics
NPI:1538811807
Name:COURTNEY LEVY DANIELS, LICENSED MENTAL HEALTH COUNSELOR PLLC
Entity type:Organization
Organization Name:COURTNEY LEVY DANIELS, LICENSED MENTAL HEALTH COUNSELOR PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:COURTNEY
Authorized Official - Middle Name:LEVY
Authorized Official - Last Name:DANIELS
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:212-547-9869
Mailing Address - Street 1:4428 PURVES ST APT 11M
Mailing Address - Street 2:
Mailing Address - City:LONG ISLAND CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11101-3071
Mailing Address - Country:US
Mailing Address - Phone:301-792-7926
Mailing Address - Fax:
Practice Address - Street 1:4428 PURVES ST APT 11M
Practice Address - Street 2:
Practice Address - City:LONG ISLAND CITY
Practice Address - State:NY
Practice Address - Zip Code:11101-3071
Practice Address - Country:US
Practice Address - Phone:301-792-7926
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-19
Last Update Date:2022-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1902323785OtherCOURTNEY LEVY