Basic Information
| Provider Information | |||||||||
| NPI: | 1457794547 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | IFTEKHAR | ||||||||
| FirstName: | SHEHLA | ||||||||
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| Credential: | LMHC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 397 PLAINFIELD AVE | ||||||||
| Address2: | |||||||||
| City: | FLORAL PARK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 110013053 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5162416127 | ||||||||
| FaxNumber: | 5163522091 | ||||||||
| Practice Location | |||||||||
| Address1: | 14015 SANFORD AVE STE B | ||||||||
| Address2: | |||||||||
| City: | FLUSHING | ||||||||
| State: | NY | ||||||||
| PostalCode: | 113552688 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7183588288 | ||||||||
| FaxNumber: | 7183585265 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/09/2013 | ||||||||
| LastUpdateDate: | 04/09/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | P86542 | NY | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.