Provider Demographics
NPI:1497462170
Name:WINDEVOXCHEL, JOSE GABRIEL (MHC-LP)
Entity Type:Individual
Prefix:
First Name:JOSE
Middle Name:GABRIEL
Last Name:WINDEVOXCHEL
Suffix:
Gender:M
Credentials:MHC-LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113 UNIVERSITY PL, 11TH FL
Mailing Address - Street 2:OFFICES A & B
Mailing Address - City:MANHATTAN
Mailing Address - State:NY
Mailing Address - Zip Code:10003
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:113 UNIVERSITY PL, 11TH FL
Practice Address - Street 2:OFFICES A & B
Practice Address - City:MANHATTAN
Practice Address - State:NY
Practice Address - Zip Code:10003
Practice Address - Country:US
Practice Address - Phone:412-465-0513
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-01
Last Update Date:2022-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY118869-01101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty