Provider Demographics
NPI:1134940240
Name:SOOKLALL, PRIYA (MHC-I)
Entity type:Individual
Prefix:
First Name:PRIYA
Middle Name:
Last Name:SOOKLALL
Suffix:
Gender:F
Credentials:MHC-I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 E EVERGREEN RD
Mailing Address - Street 2:
Mailing Address - City:NEW CITY
Mailing Address - State:NY
Mailing Address - Zip Code:10956-5145
Mailing Address - Country:US
Mailing Address - Phone:845-818-6286
Mailing Address - Fax:
Practice Address - Street 1:3 E EVERGREEN RD
Practice Address - Street 2:
Practice Address - City:NEW CITY
Practice Address - State:NY
Practice Address - Zip Code:10956-5145
Practice Address - Country:US
Practice Address - Phone:845-818-6286
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-21
Last Update Date:2024-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health