| Blossoming Cherry Mental Health Counseling Services P.c. | |
|
213 Hempstead Ave Unit A Lynbrook NY 11563-1656 | |
| (516) 256-9523 | |
| Not Available |
| Full Name | Blossoming Cherry Mental Health Counseling Services P.c. |
|---|---|
| Speciality | Counselor |
| Location | 213 Hempstead Ave Unit A, Lynbrook, New York |
| Authorized Official Name and Position | Jennifer Derri (OWNER) |
| Authorized Official Contact | 5162569523 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Blossoming Cherry Mental Health Counseling Services P.c. 213 Hempstead Ave Unit A Lynbrook NY 11563-1656 Ph: (516) 256-9523 | Blossoming Cherry Mental Health Counseling Services P.c. 213 Hempstead Ave Unit A Lynbrook NY 11563-1656 Ph: (516) 256-9523 |
| NPI Number | 1689238495 |
|---|---|
| Provider Enumeration Date | 04/26/2019 |
| Last Update Date | 03/31/2023 |
| Certification Date | 03/31/2023 |
| Medicare PECOS PAC ID | 3072054790 |
|---|---|
| Medicare Enrollment ID | O20240923000650 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689238495 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Jennifer Lynn Derri |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1124482963 PECOS PAC ID: 4981145604 Enrollment ID: I20240923000730 |
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