Provider Demographics
NPI:1578213278
Name:COUNSELING TO COMFORT, MARRIAGE AND FAMILY THERAPY SERVICES PLLC
Entity Type:Organization
Organization Name:COUNSELING TO COMFORT, MARRIAGE AND FAMILY THERAPY SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:QUINELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:HICKMAN
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:646-883-0758
Mailing Address - Street 1:99 WALL ST STE 139
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10005-4301
Mailing Address - Country:US
Mailing Address - Phone:646-883-0758
Mailing Address - Fax:
Practice Address - Street 1:920 METCALF AVE APT 20K
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10473-4034
Practice Address - Country:US
Practice Address - Phone:646-883-0758
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-25
Last Update Date:2022-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)