Provider Demographics
NPI:1730626896
Name:CONSTANTINOU, MARIA (MFT)
Entity type:Individual
Prefix:MS
First Name:MARIA
Middle Name:
Last Name:CONSTANTINOU
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2608 BAYSIDE LN
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11358-1054
Mailing Address - Country:US
Mailing Address - Phone:917-563-1557
Mailing Address - Fax:
Practice Address - Street 1:2608 BAYSIDE LN
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11358-1054
Practice Address - Country:US
Practice Address - Phone:917-563-1557
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-27
Last Update Date:2017-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001372106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist