Provider Demographics
NPI:1205046190
Name:PROKHIY, LYUDMILA (LMHC, LMFT)
Entity Type:Individual
Prefix:
First Name:LYUDMILA
Middle Name:
Last Name:PROKHIY
Suffix:
Gender:F
Credentials:LMHC, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:74 GIBSON BLVD
Mailing Address - Street 2:APT. 2-B
Mailing Address - City:VALLEY STREAM
Mailing Address - State:NY
Mailing Address - Zip Code:11581-2041
Mailing Address - Country:US
Mailing Address - Phone:516-812-8818
Mailing Address - Fax:
Practice Address - Street 1:1234 W BROADWAY
Practice Address - Street 2:SUITE 2
Practice Address - City:HEWLETT
Practice Address - State:NY
Practice Address - Zip Code:11557-1929
Practice Address - Country:US
Practice Address - Phone:516-376-0865
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2022-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000279101YM0800X
NY000566106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health