Provider Demographics
NPI:1982383634
Name:BEEPAT, ANNAMIKA (LMFT)
Entity Type:Individual
Prefix:
First Name:ANNAMIKA
Middle Name:
Last Name:BEEPAT
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:625 LAFAYETTE AVE
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:NY
Mailing Address - Zip Code:10552-3815
Mailing Address - Country:US
Mailing Address - Phone:347-948-1766
Mailing Address - Fax:
Practice Address - Street 1:14108 JEWEL AVE
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11367-1618
Practice Address - Country:US
Practice Address - Phone:518-313-5104
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-11
Last Update Date:2024-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002128-01106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist