LIFESPAN WELLNESS MARRIAGE & FAMILY THERAPY PLLC (NPI# 1982185161) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982185161 |
| Entity Type | Organization |
| Organization Name | LIFESPAN WELLNESS MARRIAGE & FAMILY THERAPY PLLC |
| Practice Address |
21333 39th Ave Ste 235 Bayside NY 11361-2174 |
| Mailing Address |
2608 Bayside Ln Flushing NY 11358-1054 |
| Practice Telephone | 9179136441 |
| Enumeration Date | 2018-08-24 |
| Last Update Date | 2018-11-30 |
| Authorized Official Name | MS. MARIA CONSTANTINOU (DIRECTOR) |
| Authorized Official Telephone | 9179136441 |
| Authorized Official Credential | LMFT |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 106H00000X | Marriage & Family Therapist | 001372 | NY | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | NPPES | 1730626896 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2391 Bell Blvd Ste 202, Flushing, NY 113602019 | 9179136441 |
| Street Address |
21333 39TH AVE STE 235 |
| City | BAYSIDE |
| State | NY |
| Zip Code | 11361-2174 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467078055 | Nicole E. Sarracco | Speech-Language Pathologist | 215 - 46 39th Avenue, Flushing, NY 11361 | 2020-06-19 |
| 1689294381 | Terri Robin Will | Registered Nurse | 3416 2019th Street, Queens, NY 11361 | 2020-04-22 |
| 1295364875 | Melanie Besthoff | Speech-Language Pathologist | 215-46 39th Avenue, Flushing, NY 11361 | 2020-04-05 |
| 1790339844 | Alana Valle | Occupational Therapist | 20947 34th Rd, Bayside, NY 11361 | 2019-07-26 |
| 1881175826 | Eva Mui | Pharmacist | 212 Northern Blvd, Bayside, NY 11361 | 2018-08-28 |
| 1063908531 | Hongik Acupuncture N.y. P.C. | Acupuncturist | 21441 42nd Ave Ste 4c, Bayside, NY 11361 | 2018-07-07 |
| 1093233694 | Karen Trentacosta | Registered Nurse | 40-04a Bell Boulevard, Bayside, NY 11361 | 2017-09-03 |
| 1801310131 | Hee Gi An | Dentist | 42-05 204th St, Flr 2, Bayside, NY 11361 | 2017-07-28 |
| 1780113050 | Miaoying Zhu | Social Worker | 217-63 Corbett Rd, Bayside, NY 11361 | 2017-06-08 |
| 1679016265 | Daniela Ragusa | Speech-Language Pathologist | 221-21 Corbett Road, Bayside, NY 11361 | 2016-11-30 |
| Find all providers in zip 11361 | ||||
| Taxonomy Code | 106H00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Marriage & Family Therapist |
| A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255520771 | Victoria V Vance | Marriage & Family Therapist | 582 Indianola Rd, Bayside, CA 95524-9334 | 2007-10-21 |
| 1790840494 | Ramon Arturo Blandino | Marriage & Family Therapist | 39-26 Clearview Expressway, 2nd Floor, Bayside, NY 11361 | 2006-12-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326649146 | Cosmic Psych-medx | Marriage & Family Therapist | 2065 E 54th St Apt 2, Brooklyn, NY 11234-4750 | 2020-11-06 |
| 1093316309 | Jessica Janik | Marriage & Family Therapist | 625 Panorama Trl Ste 220, Rochester, NY 14625-2432 | 2020-11-03 |
| 1528666054 | Esther Mann | Marriage & Family Therapist | 1226 W Broadway # L-2, Hewlett, NY 11557-1923 | 2020-10-16 |
| 1205434883 | Rachel Davies | Marriage & Family Therapist | 8641 Cobalt Dr, Cicero, NY 13039-8943 | 2020-10-15 |
| 1669079935 | Tiffany Sheppard | Marriage & Family Therapist | 1057 Boynton Ave Apt 2a, Bronx, NY 10472-5761 | 2020-10-08 |
| 1528665205 | Aurela Gjura | Marriage & Family Therapist | 432 E 149th St Fl 3, Bronx, NY 10455-1343 | 2020-10-06 |
| 1326645920 | Oksana Isakharov | Marriage & Family Therapist | Remote Telehealth Due To Pandemic, Remote Telehealth Due To Pandemic, NY 11040 | 2020-10-06 |
| 1265039168 | Christina Berdebes | Marriage & Family Therapist | 11123 76th Rd Apt C5, Forest Hills, NY 11375-6434 | 2020-10-04 |
| 1144827122 | Rachel Kinsella | Marriage & Family Therapist | 141 W 26th St Apt 4b, New York, NY 10001-6800 | 2020-10-03 |
| 1720695554 | Katie Lynn Helpley Marriage & Family Therapist Pllc | Marriage & Family Therapist | 550 Stony Brook Ct Ste 3, Newburgh, NY 12550-6557 | 2020-09-25 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.