Provider Demographics
NPI:1134954928
Name:INNER REFLECTIONS MENTAL HEALTH COUNSELING P.C.
Entity type:Organization
Organization Name:INNER REFLECTIONS MENTAL HEALTH COUNSELING P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:ANASTASIA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:POLAR
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:516-978-6694
Mailing Address - Street 1:338 JERICHO TPKE STE 156
Mailing Address - Street 2:
Mailing Address - City:SYOSSET
Mailing Address - State:NY
Mailing Address - Zip Code:11791-4507
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:136 WOODBURY RD STE L4
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:NY
Practice Address - Zip Code:11797-1411
Practice Address - Country:US
Practice Address - Phone:516-978-6694
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-03
Last Update Date:2024-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty