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Individual

LUIS FERNANDEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CASAC

Contact information

Practice address
2976 NORTHERN BLVD, 2ND FL, LONG ISLAND CITY, NY 11101-2822
(212) 691-7554
(347) 510-3457
Mailing address
2976 NORTHERN BLVD, 2ND FL, LONG ISLAND CITY, NY 11101-2822
(212) 691-7554
(347) 510-3457

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
18448
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02740141
NY
Enumeration date
05/05/2014
Last updated
05/05/2014
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