Provider Demographics
NPI:1841581006
Name:HISPANIC COUNSELING CENTER
Entity Type:Organization
Organization Name:HISPANIC COUNSELING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:L
Authorized Official - Last Name:CARDONA
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:516-538-2613
Mailing Address - Street 1:344 FULTON AVE
Mailing Address - Street 2:
Mailing Address - City:HEMPSTEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11550-3923
Mailing Address - Country:US
Mailing Address - Phone:516-538-2613
Mailing Address - Fax:
Practice Address - Street 1:344 FULTON AVE
Practice Address - Street 2:
Practice Address - City:HEMPSTEAD
Practice Address - State:NY
Practice Address - Zip Code:11550-3923
Practice Address - Country:US
Practice Address - Phone:516-538-2613
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-22
Last Update Date:2011-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1023182094302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization