Provider Demographics
NPI:1760003503
Name:MUJIB, MASHARAT (MHC-LP)
Entity Type:Individual
Prefix:
First Name:MASHARAT
Middle Name:
Last Name:MUJIB
Suffix:
Gender:F
Credentials:MHC-LP
Other - Prefix:
Other - First Name:MASHARAT
Other - Middle Name:
Other - Last Name:MUJIB
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMHC
Mailing Address - Street 1:5019 94TH ST
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11373-3286
Mailing Address - Country:US
Mailing Address - Phone:347-201-3478
Mailing Address - Fax:
Practice Address - Street 1:5019 94TH ST APT 2
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11373-3286
Practice Address - Country:US
Practice Address - Phone:347-201-3478
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-04
Last Update Date:2020-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP104065101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health