Provider Demographics
NPI:1225387772
Name:MENTAL HEALTH ASSOCIATION OF NASSAU COUNTY
Entity Type:Organization
Organization Name:MENTAL HEALTH ASSOCIATION OF NASSAU COUNTY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:NEMIROFF
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:516-489-2322
Mailing Address - Street 1:16 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HEMPSTEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11550-4020
Mailing Address - Country:US
Mailing Address - Phone:516-489-2322
Mailing Address - Fax:516-489-2784
Practice Address - Street 1:21 THE TER
Practice Address - Street 2:
Practice Address - City:PLANDOME
Practice Address - State:NY
Practice Address - Zip Code:11030-1348
Practice Address - Country:US
Practice Address - Phone:516-365-1249
Practice Address - Fax:516-365-9799
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-30
Last Update Date:2012-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY225X00000X, 315P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty
No315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual DisabilitiesGroup - Single Specialty