Provider Demographics
NPI:1023182094
Name:HISPANIC COUNSELING CENTER, INC
Entity Type:Organization
Organization Name:HISPANIC COUNSELING CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CLAUDIA
Authorized Official - Middle Name:MARGARITA
Authorized Official - Last Name:BOYLE
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:516-538-2613
Mailing Address - Street 1:344 FULTON AVENUE
Mailing Address - Street 2:
Mailing Address - City:HEMPSTEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11550
Mailing Address - Country:US
Mailing Address - Phone:516-538-2612
Mailing Address - Fax:516-538-2515
Practice Address - Street 1:344 FULTON AVENUE
Practice Address - Street 2:
Practice Address - City:HEMPSTEAD
Practice Address - State:NY
Practice Address - Zip Code:11550-3907
Practice Address - Country:US
Practice Address - Phone:516-538-2613
Practice Address - Fax:516-538-0772
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-20
Last Update Date:2021-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY150210806101YA0400X, 101YA0400X
NY261QM0801X, 261QM0801X
NY7768100A261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Single Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01037952 MHMedicaid
NY02000131 0MRDDMedicaid
NY03865890Medicaid
NY03865890Medicaid
NY01037952 MHMedicaid
NY02000131Medicaid
NY01037952MHMedicaid
NY01037952Medicaid