Provider Demographics
NPI:1720342249
Name:PLAKHIN, ALEX (MA, MS)
Entity type:Individual
Prefix:MR
First Name:ALEX
Middle Name:
Last Name:PLAKHIN
Suffix:
Gender:M
Credentials:MA, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2450 HARING ST
Mailing Address - Street 2:# 1-H
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-1867
Mailing Address - Country:US
Mailing Address - Phone:917-375-9348
Mailing Address - Fax:718-368-0924
Practice Address - Street 1:2450 HARING ST
Practice Address - Street 2:# 1-H
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-1867
Practice Address - Country:US
Practice Address - Phone:917-375-9348
Practice Address - Fax:718-368-0924
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-29
Last Update Date:2012-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY348704091101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY348704091OtherSTUDENTS WITH DISABILITIES