Individual
NINA LEI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
119 W 57TH ST, SUITE 1100, NEW YORK, NY 10019-2303
(646) 632-2807
Mailing address
119 W 57TH ST STE 1100, NEW YORK, NY 10019-2401
(646) 543-5987
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
007155
NY
103TC1900X
Counseling Psychologist
Primary
026853
NY
Other
Enumeration date
06/08/2016
Last updated
07/17/2026
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