Provider Demographics
NPI:1578064499
Name:ANGELS OF MERCY COUNSELING CENTER INC.
Entity Type:Organization
Organization Name:ANGELS OF MERCY COUNSELING CENTER INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MICHELE
Authorized Official - Middle Name:
Authorized Official - Last Name:BUTLER
Authorized Official - Suffix:I
Authorized Official - Credentials:
Authorized Official - Phone:631-520-8240
Mailing Address - Street 1:85 SCHLEIGEL BLVD
Mailing Address - Street 2:
Mailing Address - City:AMITYVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11701-1320
Mailing Address - Country:US
Mailing Address - Phone:631-608-1740
Mailing Address - Fax:
Practice Address - Street 1:85 SCHLEIGEL BLVD
Practice Address - Street 2:
Practice Address - City:AMITYVILLE
Practice Address - State:NY
Practice Address - Zip Code:11701-1320
Practice Address - Country:US
Practice Address - Phone:631-608-1740
Practice Address - Fax:631-608-2989
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-26
Last Update Date:2018-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2292L001251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health