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Organization
AGELESS MIND NY INC
Active
Organization
AGELESS MIND NY INC
Active
Other names
Ageless Mind NY
Organization subpart
No
Provider details
NPI number
Authorized official
IZABELLE REYHANIAN HAKIM LCSW, EMPA (OWNER)
(516) 726-0301
Entity
Organization
Contact information
Practice address
55 NORTHERN BLVD STE 406, GREAT NECK, NY 11021-4058
(516) 726-0301
Mailing address
55 NORTHERN BLVD STE 406, GREAT NECK, NY 11021-4058
(516) 726-0301
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
078204-1
NY
Other
Enumeration date
09/05/2018
Last updated
01/10/2019
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