Provider Demographics
NPI:1043800303
Name:GRACE SUH MENTAL HEALTH COUNSELING, P.C
Entity Type:Organization
Organization Name:GRACE SUH MENTAL HEALTH COUNSELING, P.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED MENTAL HEALTH COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:GRACE
Authorized Official - Middle Name:
Authorized Official - Last Name:SUH
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:917-280-1043
Mailing Address - Street 1:206 E 95TH ST APT 4A
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-3816
Mailing Address - Country:US
Mailing Address - Phone:917-280-1043
Mailing Address - Fax:
Practice Address - Street 1:3261 JOHNSON AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10463-3504
Practice Address - Country:US
Practice Address - Phone:917-280-1043
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-21
Last Update Date:2021-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)