Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Lic Marriage and Family Therapy PLLC

Organization Marriage & Family Therapist · NPI 1306412077

Lic Marriage and Family Therapy PLLC is a Marriage & Family Therapist in Long Island City, New York. Registered with an NPI since 2021.

In the registry since
2021
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

3164 21st St # 121
Long Island City, NY 11106-4573
Phone: (631) 365-9350
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Marriage & Family Therapist (primary) Taxonomy 106H00000X

Record details

NPI number1306412077
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jennifer Disomma — Marriage And Family Therapist · (631) 365-9350
NPI enumeratedJune 2, 2021
Last updated in NPPESJuly 27, 2023
Certification dateJuly 27, 2023
Mailing address3164 21st St # 121, Long Island City, NY 11106-4573

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