Provider Demographics
NPI:1962006494
Name:MUSHEYEV, MAGDALENA MARIA (LMHC)
Entity Type:Individual
Prefix:
First Name:MAGDALENA
Middle Name:MARIA
Last Name:MUSHEYEV
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6043 60TH ST FL 1
Mailing Address - Street 2:
Mailing Address - City:MASPETH
Mailing Address - State:NY
Mailing Address - Zip Code:11378-3531
Mailing Address - Country:US
Mailing Address - Phone:917-239-2489
Mailing Address - Fax:
Practice Address - Street 1:6043 60TH ST FL 1
Practice Address - Street 2:
Practice Address - City:MASPETH
Practice Address - State:NY
Practice Address - Zip Code:11378-3531
Practice Address - Country:US
Practice Address - Phone:917-239-2489
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-25
Last Update Date:2020-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010497-01101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health