Individual
CONSUELO DA COSTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
77 WATERSIDE AVE, NORTHPORT, NY 11768-2149
(516) 435-4079
Mailing address
77 WATERSIDE AVE, NORTHPORT, NY 11768-2149
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
NY
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
NY
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
Primary
—
NY
Other
Enumeration date
10/15/2025
Last updated
10/15/2025
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