Provider Demographics
NPI:1821859737
Name:FARHANE, ASIYAH (MHC-LP)
Entity Type:Individual
Prefix:
First Name:ASIYAH
Middle Name:
Last Name:FARHANE
Suffix:
Gender:F
Credentials:MHC-LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:395 ANN ST # 1L
Mailing Address - Street 2:
Mailing Address - City:NEWBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12550-5335
Mailing Address - Country:US
Mailing Address - Phone:347-740-8403
Mailing Address - Fax:
Practice Address - Street 1:1284 E 19TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11230-5404
Practice Address - Country:US
Practice Address - Phone:929-552-5134
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-17
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP124078101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health