| Selff Recovery Coaching | |
|
2150 E Tremont Ave Apt 5g Bronx NY 10462-5732 | |
| (917) 383-5753 | |
| Not Available |
| Full Name | Selff Recovery Coaching |
|---|---|
| Speciality | Clinic/center - Rehabilitation, Substance Use Disorder |
| Location | 2150 E Tremont Ave Apt 5g, Bronx, New York |
| Authorized Official Name and Position | Tylie Yolander Mitchell (OWNER) |
| Authorized Official Contact | 1917383575 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Selff Recovery Coaching 2150 E Tremont Ave Apt 5g Bronx NY 10462-5732 Ph: (917) 383-5753 | Selff Recovery Coaching 2150 E Tremont Ave Apt 5g Bronx NY 10462-5732 Ph: (917) 383-5753 |
| NPI Number | 1164155305 |
|---|---|
| Provider Enumeration Date | 07/06/2022 |
| Last Update Date | 07/06/2022 |
| Certification Date | 04/08/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164155305 | NPI | - | NPPES |
| 18102958-01 | Other | NY | FEE FOR SERVICE |
| 18102958-01 | Medicaid | NY | |
| 18102958-01 | Other | NM | 18102958-01 |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TP2701X | Psychologist - Group Psychotherapy | (* (Not Available)) | Secondary |
| 261QR0405X | Clinic/center - Rehabilitation, Substance Use Disorder | (* (Not Available)) | Primary |
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