Doctor Name: | ALLISON BEREST |
NPI Number: | 1548627151 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MA |
License Number: | 006844 |
Business Practice Address: | 3 Roosevelt St Glen Head, NY - 115451420 |
Business Phone Number: | 5166628750 |
Business Fax Number: | |
Mailing Address: | 3 Roosevelt St, GLEN HEAD |
State: | NY |
Postal Code: | 115451420 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 01/27/2016 |
NPI Last Update Date: | 01/27/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 006844 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |