Provider Demographics
NPI:1992025902
Name:CRESPO, RAQUEL A (LMHC)
Entity Type:Individual
Prefix:
First Name:RAQUEL
Middle Name:A
Last Name:CRESPO
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 1:7018 57TH DR
Mailing Address - Street 2:APT 1
Mailing Address - City:MASPETH
Mailing Address - State:NY
Mailing Address - Zip Code:11378-1915
Mailing Address - Country:US
Mailing Address - Phone:646-251-6446
Mailing Address - Fax:
Practice Address - Street 1:7018 57TH DR
Practice Address - Street 2:APT 1
Practice Address - City:MASPETH
Practice Address - State:NY
Practice Address - Zip Code:11378-1915
Practice Address - Country:US
Practice Address - Phone:646-251-6446
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-02
Last Update Date:2010-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004493101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health