Provider Demographics
NPI:1083387930
Name:KQH MENTAL HEALTH COUNSELING P.L.L.C.
Entity Type:Organization
Organization Name:KQH MENTAL HEALTH COUNSELING P.L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PSYCHOTHERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:KEZZIA
Authorized Official - Middle Name:
Authorized Official - Last Name:QUINTYNE-HILAIRE
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:347-889-0805
Mailing Address - Street 1:1112 ROTTKAMP ST
Mailing Address - Street 2:
Mailing Address - City:VALLEY STREAM
Mailing Address - State:NY
Mailing Address - Zip Code:11580-2335
Mailing Address - Country:US
Mailing Address - Phone:347-889-0805
Mailing Address - Fax:
Practice Address - Street 1:70 E SUNRISE HWY STE 500
Practice Address - Street 2:
Practice Address - City:VALLEY STREAM
Practice Address - State:NY
Practice Address - Zip Code:11581-1233
Practice Address - Country:US
Practice Address - Phone:516-200-4672
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-27
Last Update Date:2021-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1275929234OtherBEHAVIORAL HEALTH
NJ1952908261OtherBEHAVIORAL HEALTH