Provider Demographics
NPI:1003496308
Name:LONG ISLAND NC MENTAL HEALTH COUNSELING P.C.
Entity type:Organization
Organization Name:LONG ISLAND NC MENTAL HEALTH COUNSELING P.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NICCOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:CARRERO
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:516-341-8924
Mailing Address - Street 1:24520 GRAND CENTRAL PKWY APT 5E
Mailing Address - Street 2:
Mailing Address - City:BELLEROSE
Mailing Address - State:NY
Mailing Address - Zip Code:11426-2711
Mailing Address - Country:US
Mailing Address - Phone:516-341-8924
Mailing Address - Fax:
Practice Address - Street 1:1129 NORTHERN BOULEVARD
Practice Address - Street 2:SUITE 404- #0830
Practice Address - City:MANHASSET
Practice Address - State:NY
Practice Address - Zip Code:11030-1103
Practice Address - Country:US
Practice Address - Phone:516-360-0147
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-11
Last Update Date:2021-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty