Provider Demographics
NPI:1003424227
Name:SPINA, RHEA N (LMHC)
Entity Type:Individual
Prefix:MS
First Name:RHEA
Middle Name:N
Last Name:SPINA
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:444 CLARICE BLVD
Mailing Address - Street 2:
Mailing Address - City:HOLBROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11741-5742
Mailing Address - Country:US
Mailing Address - Phone:631-553-4453
Mailing Address - Fax:
Practice Address - Street 1:444 CLARICE BLVD
Practice Address - Street 2:
Practice Address - City:HOLBROOK
Practice Address - State:NY
Practice Address - Zip Code:11741-5742
Practice Address - Country:US
Practice Address - Phone:631-553-4453
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-14
Last Update Date:2020-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010383101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health