Provider Demographics
NPI:1326787540
Name:SYNERGY MENTAL HEALTH COUNSELING
Entity Type:Organization
Organization Name:SYNERGY MENTAL HEALTH COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:SYBIL
Authorized Official - Middle Name:ELIZABETH-JOE
Authorized Official - Last Name:TABUTEAU CHERISME
Authorized Official - Suffix:
Authorized Official - Credentials:MA ED, LMHC
Authorized Official - Phone:917-648-7115
Mailing Address - Street 1:108 S FRANKLIN AVE STE 4
Mailing Address - Street 2:
Mailing Address - City:VALLEY STREAM
Mailing Address - State:NY
Mailing Address - Zip Code:11580-6105
Mailing Address - Country:US
Mailing Address - Phone:516-303-9925
Mailing Address - Fax:516-303-9920
Practice Address - Street 1:108 S FRANKLIN AVE STE 4
Practice Address - Street 2:
Practice Address - City:VALLEY STREAM
Practice Address - State:NY
Practice Address - Zip Code:11580-6105
Practice Address - Country:US
Practice Address - Phone:516-303-9925
Practice Address - Fax:516-303-9920
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-04
Last Update Date:2022-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)