Provider Demographics
NPI:1477297661
Name:MOGILENSKY, SAMUEL (LMHC)
Entity Type:Individual
Prefix:
First Name:SAMUEL
Middle Name:
Last Name:MOGILENSKY
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39 LAMBERT LN
Mailing Address - Street 2:
Mailing Address - City:NEW ROCHELLE
Mailing Address - State:NY
Mailing Address - Zip Code:10804-1009
Mailing Address - Country:US
Mailing Address - Phone:914-306-5899
Mailing Address - Fax:
Practice Address - Street 1:39 LAMBERT LN
Practice Address - Street 2:
Practice Address - City:NEW ROCHELLE
Practice Address - State:NY
Practice Address - Zip Code:10804-1009
Practice Address - Country:US
Practice Address - Phone:240-595-2732
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-24
Last Update Date:2022-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009991101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health