Individual
MS. STACEY ABIGAIL MOHAMED
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MHC-LP
Contact information
Practice address
16318 JAMAICA AVE, JAMAICA, NY 11432-4919
(718) 658-0010
(718) 658-2909
Mailing address
8635 104TH ST, RICHMOND HILL, NY 11418-1539
(917) 510-3777
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
P102570
NY
101YM0800X
Mental Health Counselor
P102570
NY
Other
Enumeration date
09/20/2019
Last updated
09/20/2019
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