Provider Demographics
NPI:1073397261
Name:CALIZAIRE, BIANCA HALLERIE (MHC-LP)
Entity Type:Individual
Prefix:
First Name:BIANCA
Middle Name:HALLERIE
Last Name:CALIZAIRE
Suffix:
Gender:F
Credentials:MHC-LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:716 JEFFERSON AVE APT 3B
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11221-5197
Mailing Address - Country:US
Mailing Address - Phone:718-603-0543
Mailing Address - Fax:
Practice Address - Street 1:716 JEFFERSON AVE APT 3B
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11221-5197
Practice Address - Country:US
Practice Address - Phone:718-603-0543
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-21
Last Update Date:2023-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health