| Therapeutic Wellness Licensed Mental Health Counseling Pc | |
|
443 Hudson Ave Mechanicville NY 12118-4503 | |
| (516) 930-3571 | |
| Not Available |
| Full Name | Therapeutic Wellness Licensed Mental Health Counseling Pc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 443 Hudson Ave, Mechanicville, New York |
| Authorized Official Name and Position | Jeff D Mckenzie (PRESIDENT) |
| Authorized Official Contact | 5185067880 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Therapeutic Wellness Licensed Mental Health Counseling Pc 443 Hudson Ave Mechanicville NY 12118-4503 Ph: (516) 930-3571 | Therapeutic Wellness Licensed Mental Health Counseling Pc 443 Hudson Ave Mechanicville NY 12118-4503 Ph: (516) 930-3571 |
| NPI Number | 1447030333 |
|---|---|
| Provider Enumeration Date | 09/29/2023 |
| Last Update Date | 10/05/2023 |
| Certification Date | 10/05/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447030333 | NPI | - | NPPES |
| 1679165310 | Medicaid | NY | |
| 1699335973 | Medicaid | NY | |
| 1467685347 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |