Provider Demographics
NPI:1275209603
Name:BURGOS, JOAQUIN E (CASAC-T)
Entity Type:Individual
Prefix:MR
First Name:JOAQUIN
Middle Name:E
Last Name:BURGOS
Suffix:
Gender:M
Credentials:CASAC-T
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1020 NEILSON ST APT 1F
Mailing Address - Street 2:
Mailing Address - City:FAR ROCKAWAY
Mailing Address - State:NY
Mailing Address - Zip Code:11691-5025
Mailing Address - Country:US
Mailing Address - Phone:718-749-3023
Mailing Address - Fax:
Practice Address - Street 1:NEW HORIZON COUNSELING CENTER
Practice Address - Street 2:50 W HAWTHORNE AVENUE 3RD FLOOR
Practice Address - City:VALLEY STREAM
Practice Address - State:NY
Practice Address - Zip Code:11580
Practice Address - Country:US
Practice Address - Phone:516-569-6600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-17
Last Update Date:2021-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY257123101Y00000X
NY33640101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101Y00000XBehavioral Health & Social Service ProvidersCounselor