Provider Demographics
NPI:1134945785
Name:MATHIASEN, LAMEES AMIRAH
Entity type:Individual
Prefix:MS
First Name:LAMEES
Middle Name:AMIRAH
Last Name:MATHIASEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LAMEES
Other - Middle Name:AMIRAH
Other - Last Name:ELGHANIMI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:207 E 37TH ST APT 0BD
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-3160
Mailing Address - Country:US
Mailing Address - Phone:425-241-8029
Mailing Address - Fax:
Practice Address - Street 1:207 E 37TH ST APT 0BD
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-3160
Practice Address - Country:US
Practice Address - Phone:425-241-8029
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-27
Last Update Date:2024-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty