Provider Demographics
NPI:1376794016
Name:MIZZI, AMIE B (LMHC)
Entity Type:Individual
Prefix:MS
First Name:AMIE
Middle Name:B
Last Name:MIZZI
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:135 TRINITY PL
Mailing Address - Street 2:
Mailing Address - City:WEST HEMPSTEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11552-1746
Mailing Address - Country:US
Mailing Address - Phone:917-359-8395
Mailing Address - Fax:
Practice Address - Street 1:135 TRINITY PL
Practice Address - Street 2:
Practice Address - City:WEST HEMPSTEAD
Practice Address - State:NY
Practice Address - Zip Code:11552-1746
Practice Address - Country:US
Practice Address - Phone:917-359-8395
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-30
Last Update Date:2015-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000745-1101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health