Provider Demographics
NPI:1811878937
Name:SHAMEELA INDERDEO MENTAL HEALTH COUNSELOR P.C.
Entity type:Organization
Organization Name:SHAMEELA INDERDEO MENTAL HEALTH COUNSELOR P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:SHAMEELA
Authorized Official - Middle Name:
Authorized Official - Last Name:INDERDEO
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:516-776-6360
Mailing Address - Street 1:1232 13TH ST
Mailing Address - Street 2:
Mailing Address - City:WEST BABYLON
Mailing Address - State:NY
Mailing Address - Zip Code:11704-3212
Mailing Address - Country:US
Mailing Address - Phone:516-776-6360
Mailing Address - Fax:631-888-1624
Practice Address - Street 1:2136 DEER PARK AVE # 29
Practice Address - Street 2:
Practice Address - City:DEER PARK
Practice Address - State:NY
Practice Address - Zip Code:11729-1306
Practice Address - Country:US
Practice Address - Phone:516-776-6360
Practice Address - Fax:631-888-1624
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-08
Last Update Date:2025-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty