Basic Information
| Provider Information | |||||||||
| NPI: | 1104286111 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BIJRAJ | ||||||||
| FirstName: | NIRMALA | ||||||||
| MiddleName: | DEVI | ||||||||
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| Credential: | LMHC, NCC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 25 CHAPEL ST | ||||||||
| Address2: | |||||||||
| City: | BROOKLYN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 112011952 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7183980153 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 25 CHAPEL ST STE 901 | ||||||||
| Address2: | |||||||||
| City: | BROOKLYN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 112011916 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7183980153 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/03/2016 | ||||||||
| LastUpdateDate: | 04/25/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | 006933 | NY | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health | 101YP2500X | 345889 | NY | N | Behavioral Health & Social Service Providers | Counselor | Professional |
No ID Information.