Provider Demographics
NPI:1396114948
Name:SOBHRAJ, ALYSIA (LMHC)
Entity type:Individual
Prefix:MISS
First Name:ALYSIA
Middle Name:
Last Name:SOBHRAJ
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 W AMES CT STE 100
Mailing Address - Street 2:
Mailing Address - City:PLAINVIEW
Mailing Address - State:NY
Mailing Address - Zip Code:11803-2304
Mailing Address - Country:US
Mailing Address - Phone:516-822-6111
Mailing Address - Fax:
Practice Address - Street 1:55 W AMES CT STE 100
Practice Address - Street 2:
Practice Address - City:PLAINVIEW
Practice Address - State:NY
Practice Address - Zip Code:11803-2304
Practice Address - Country:US
Practice Address - Phone:516-822-6111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-24
Last Update Date:2020-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009032101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health