Kersendria S Abdullah, MSW

Individual provider Active NPI Mental Health Counselor · Rego Park, NY

NPI 1922265115 · NPPES record last updated May 16, 2008

Key facts

NPI
1922265115
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Counselor 101YM0800X
Practice address
9729 64TH Rd
Rego Park, NY 11374-2240
Phone
(718) 896-3400
Fax
(718) 459-5621
NPI assigned
May 16, 2008
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Long Island Consultation Center, Inc. Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Yes

Addresses

Primary practice location

9729 64TH Rd
Rego Park, NY 11374-2240

Mailing address

17739 106TH Ave
Jamaica, NY 11433-1804
Phone (718) 206-1238

Other identifiers

IdentifierTypeStateIssuer
00244019MedicaidNY

Other providers in Rego Park, NY

All providers in Rego Park, NY · Mental Health Counselor in New York

Sources for this page

Verify at the official NPI Registry.