Provider Demographics
NPI:1447421136
Name:BERAKI, NAILAH G (MSED, CRC,LMHC)
Entity type:Individual
Prefix:MS
First Name:NAILAH
Middle Name:G
Last Name:BERAKI
Suffix:
Gender:F
Credentials:MSED, CRC,LMHC
Other - Prefix:MRS
Other - First Name:NAILAH
Other - Middle Name:G
Other - Last Name:BERAKI-PIERRE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMHC
Mailing Address - Street 1:100 BENCHLEY PL APT 6L
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10475-3377
Mailing Address - Country:US
Mailing Address - Phone:718-664-3986
Mailing Address - Fax:
Practice Address - Street 1:100 BENCHLEY PL APT 6L
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10475-3377
Practice Address - Country:US
Practice Address - Phone:718-664-3986
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-20
Last Update Date:2009-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY74115101Y00000X
NY002272101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor