FRESH START RELATIONAL THERAPY NPI 1023736352

NPI Information

  • NPI: 1023736352
  • Provider Name: FRESH START RELATIONAL THERAPY
  • Classification: Clinic/Center - 261QM0801X
  • Specialization: Mental Health (Including Community Mental Health Center)
  • Entity Type: Organization
  • Address: 430 PARK AVE
    NEW YORK, NY
    ZIP 10022
  • Phone: (646) 598-4575

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NPI Details

FRESH START RELATIONAL THERAPY is a mental health (including community mental health center) clinic center in New York, NY. FRESH START RELATIONAL THERAPY NPI is 1023736352. The provider is registered as an organization entity type.

The provider's business location address is:

430 PARK AVE
NEW YORK, NY
ZIP 10022-505
Phone: (646) 598-4575

The provider's authorized official is Aquandalla Davis .
The authorized official title is Licensed Marriage And Family Therap and has the following contact phone number (347) 394-9283.

The enumeration date for this NPI number is 8/22/2022 and was last updated on 8/22/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QM0801XClinic/CenterMental Health (Including Community Mental Health Center)Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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