Provider Demographics
NPI:1396205704
Name:INTERSECTIONAL MENTAL HEALTH COUNSELING
Entity Type:Organization
Organization Name:INTERSECTIONAL MENTAL HEALTH COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ALPANA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHOUDHURY
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:917-410-1139
Mailing Address - Street 1:3420 85TH ST
Mailing Address - Street 2:
Mailing Address - City:JACKSON HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11372-3242
Mailing Address - Country:US
Mailing Address - Phone:845-661-9030
Mailing Address - Fax:
Practice Address - Street 1:32 UNION SQ E STE 511
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-3244
Practice Address - Country:US
Practice Address - Phone:917-410-1139
Practice Address - Fax:917-436-9799
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-21
Last Update Date:2019-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty