Individual provider · Type 1 NPI

Samuel Austin Formanek

Mental Health Counselor · New York, NY

NPI number 1811595259 Active

Practice location

248 W 108th St
New York, NY 10025-2956

Mailing address

41 Corell Rd
Scarsdale, NY 10583-7448

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XP107181 (NY)

Mental Health Counselor: Definition to come...

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About NPI 1811595259

Samuel Austin Formanek's National Provider Identifier is 1811595259, issued on Oct 16, 2020. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in New York, NY. The record was last updated on Nov 27, 2023.