| Organization Name: | ST. RAPHAEL MENTAL HEALTH COUNSELING, PC |
| NPI Number: | 1194061325 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ALLISON RICCIARDI (PRESIDENT) |
| Mailing Address: | 10 E 16th St Huntington Station |
| State: | NY US |
| Postal Code: | 117462911 |
| Phone Number: | 6319232777 |
| Fax Number: | 6319232777 |
| NPI Enumeration Date: | 12/16/2012 |
| NPI Last Update Date: | 03/25/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 002607-1 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |