Provider Demographics
NPI:1356009716
Name:TEA FOR THE SOUL MENTAL HEALTH COUNSELING, PLLC
Entity Type:Organization
Organization Name:TEA FOR THE SOUL MENTAL HEALTH COUNSELING, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TARYN
Authorized Official - Middle Name:
Authorized Official - Last Name:CODNER-ALEXANDER
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:646-762-2524
Mailing Address - Street 1:1451 WEST AVE STE 7070
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10462-7304
Mailing Address - Country:US
Mailing Address - Phone:646-762-2524
Mailing Address - Fax:
Practice Address - Street 1:1451 WEST AVE STE 7070
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10462-7304
Practice Address - Country:US
Practice Address - Phone:646-762-2524
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-02
Last Update Date:2021-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty