Provider Demographics
NPI:1114696697
Name:MAFI, TYLER (LMHC)
Entity type:Individual
Prefix:MR
First Name:TYLER
Middle Name:
Last Name:MAFI
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:MS
Other - First Name:ANGELINA
Other - Middle Name:
Other - Last Name:MAFI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MHC
Mailing Address - Street 1:2464 28TH ST APT 1A
Mailing Address - Street 2:
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11102-1915
Mailing Address - Country:US
Mailing Address - Phone:347-814-9461
Mailing Address - Fax:
Practice Address - Street 1:32 UNION SQ E STE 1006
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-3237
Practice Address - Country:US
Practice Address - Phone:347-814-9461
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-08
Last Update Date:2024-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013941101YM0800X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health