Provider Demographics
NPI:1104205228
Name:HTMTH, INC.
Entity Type:Organization
Organization Name:HTMTH, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JANICE
Authorized Official - Middle Name:ELLEN
Authorized Official - Last Name:KALIN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:516-466-5894
Mailing Address - Street 1:79 BAYVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11021-1730
Mailing Address - Country:US
Mailing Address - Phone:516-466-5894
Mailing Address - Fax:
Practice Address - Street 1:79 BAYVIEW AVE
Practice Address - Street 2:
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11021-1730
Practice Address - Country:US
Practice Address - Phone:516-466-5894
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-21
Last Update Date:2015-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR078327-1101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA30011730Medicare PIN