Provider Demographics
NPI:1932989506
Name:EXPAND YOUR WELLNESS MENTAL HEALTH COUNSELING PLLC
Entity Type:Organization
Organization Name:EXPAND YOUR WELLNESS MENTAL HEALTH COUNSELING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MS
Authorized Official - First Name:MAGDA
Authorized Official - Middle Name:
Authorized Official - Last Name:ZAPATA
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:631-533-4163
Mailing Address - Street 1:136 BALSAM LN
Mailing Address - Street 2:
Mailing Address - City:LEVITTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:11756-4904
Mailing Address - Country:US
Mailing Address - Phone:631-533-4163
Mailing Address - Fax:
Practice Address - Street 1:136 BALSAM LN
Practice Address - Street 2:
Practice Address - City:LEVITTOWN
Practice Address - State:NY
Practice Address - Zip Code:11756-4904
Practice Address - Country:US
Practice Address - Phone:631-533-4163
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-02
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health