Provider Demographics
NPI:1609133677
Name:M I H MENTAL HEALTH COUNSELOR, PC
Entity Type:Organization
Organization Name:M I H MENTAL HEALTH COUNSELOR, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ERCILIA
Authorized Official - Middle Name:A
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:646-385-2738
Mailing Address - Street 1:311 AUDUBON AVE
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10033-4237
Mailing Address - Country:US
Mailing Address - Phone:646-385-2738
Mailing Address - Fax:
Practice Address - Street 1:311 AUDUBON AVE
Practice Address - Street 2:2ND FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10033-4237
Practice Address - Country:US
Practice Address - Phone:646-385-2738
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-16
Last Update Date:2012-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty