Individual
DR. JAMESHA NICOLE MACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD, QMHP
Contact information
Practice address
1400 OLD COUNTRY RD STE C103N, WESTBURY, NY 11590-5156
(631) 762-4812
Mailing address
1400 OLD COUNTRY RD STE C103N, WESTBURY, NY 11590-5156
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
0733004836
VA
103K00000X
Behavior Analyst
—
—
103T00000X
Psychologist
Primary
—
—
Other
Enumeration date
03/14/2022
Last updated
03/06/2025
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