Provider Demographics
NPI:1013639350
Name:VIVA WELLNESS LICENSED MENTAL HEALTH COUNSELING, PLLC
Entity Type:Organization
Organization Name:VIVA WELLNESS LICENSED MENTAL HEALTH COUNSELING, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:
Authorized Official - Last Name:GERSTEN
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:917-838-9803
Mailing Address - Street 1:70 W 87TH ST APT B
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-3566
Mailing Address - Country:US
Mailing Address - Phone:917-838-9803
Mailing Address - Fax:
Practice Address - Street 1:300 CADMAN PLZ W FL 12
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-3226
Practice Address - Country:US
Practice Address - Phone:347-689-7759
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-14
Last Update Date:2022-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty