Provider Demographics
NPI:1740368950
Name:KRAVCHENKO, ALLA (LMHC)
Entity type:Individual
Prefix:
First Name:ALLA
Middle Name:
Last Name:KRAVCHENKO
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 ALBANY TPKE BLDG 5
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:CT
Mailing Address - Zip Code:06019-2516
Mailing Address - Country:US
Mailing Address - Phone:860-325-0308
Mailing Address - Fax:888-974-1190
Practice Address - Street 1:220 E 54TH ST APT 1C
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-4838
Practice Address - Country:US
Practice Address - Phone:860-325-0308
Practice Address - Fax:888-974-1190
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-02
Last Update Date:2025-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002141101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health