Provider Demographics
NPI:1508232745
Name:DEVAS MENTAL HEALTH COUNSELING, PLLC
Entity Type:Organization
Organization Name:DEVAS MENTAL HEALTH COUNSELING, PLLC
Other - Org Name:DEVAS COUNSELING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:PECK
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:914-500-9892
Mailing Address - Street 1:1600 HARRISON AVE
Mailing Address - Street 2:G105-6
Mailing Address - City:MAMARONECK
Mailing Address - State:NY
Mailing Address - Zip Code:10543-3145
Mailing Address - Country:US
Mailing Address - Phone:914-500-9892
Mailing Address - Fax:
Practice Address - Street 1:1600 HARRISON AVE
Practice Address - Street 2:SUITE G105-6
Practice Address - City:MAMARONECK
Practice Address - State:NY
Practice Address - Zip Code:10543-3145
Practice Address - Country:US
Practice Address - Phone:914-500-9892
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-11
Last Update Date:2015-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006431101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty