Provider Demographics
NPI:1275704058
Name:GEORGOPOULOS, MARIA (LMHC, FT)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:GEORGOPOULOS
Suffix:
Gender:F
Credentials:LMHC, FT
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:
Other - Last Name:GEORGOPOULOS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMHC, FT
Mailing Address - Street 1:3555 29TH ST APT 5C
Mailing Address - Street 2:
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11106-3136
Mailing Address - Country:US
Mailing Address - Phone:347-512-0999
Mailing Address - Fax:
Practice Address - Street 1:3555 29TH ST APT 5C
Practice Address - Street 2:
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11106-3136
Practice Address - Country:US
Practice Address - Phone:347-512-0999
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-19
Last Update Date:2021-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health