Provider Demographics
NPI:1497888127
Name:BELENKY, DMITRY (LMHC)
Entity Type:Individual
Prefix:MR
First Name:DMITRY
Middle Name:
Last Name:BELENKY
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 1:12 STATION SQ
Mailing Address - Street 2:
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-5234
Mailing Address - Country:US
Mailing Address - Phone:917-371-8655
Mailing Address - Fax:
Practice Address - Street 1:12 STATION SQ
Practice Address - Street 2:
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-5234
Practice Address - Country:US
Practice Address - Phone:917-371-8655
Practice Address - Fax:917-551-7386
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-13
Last Update Date:2013-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY01040101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health