Provider Demographics
NPI:1669702411
Name:MORALES, NATASHA (MA, LMHC)
Entity type:Individual
Prefix:MS
First Name:NATASHA
Middle Name:
Last Name:MORALES
Suffix:
Gender:F
Credentials:MA, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:56 ARLINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:VALLEY STREAM
Mailing Address - State:NY
Mailing Address - Zip Code:11580-3525
Mailing Address - Country:US
Mailing Address - Phone:347-495-5554
Mailing Address - Fax:
Practice Address - Street 1:56 ARLINGTON AVE
Practice Address - Street 2:
Practice Address - City:VALLEY STREAM
Practice Address - State:NY
Practice Address - Zip Code:11580-3525
Practice Address - Country:US
Practice Address - Phone:347-495-5554
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-29
Last Update Date:2009-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004390101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health