Mishma T. L. Anderson

Individual provider Active NPI Mental Health Counselor · Roosevelt, NY

NPI 1013892306 · NPPES record last updated Aug 7, 2025

Key facts

NPI
1013892306
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Counselor 101YM0800X
Practice address
33 W Clinton Ave
Roosevelt, NY 11575-1331
Phone
(516) 514-4525
NPI assigned
Aug 7, 2025
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Yes

Addresses

Primary practice location

33 W Clinton Ave
Roosevelt, NY 11575-1331

Mailing address

33 W Clinton Ave
Roosevelt, NY 11575-1331
Phone (516) 514-4525

Other practice location 1

108 S Franklin Ave Ste 3
Valley Stream, NY 11580-6105
Phone (516) 303-9925

Other providers in Roosevelt, NY

All providers in Roosevelt, NY · Mental Health Counselor in New York

Sources for this page

Verify at the official NPI Registry.