Provider Demographics
NPI:1609458553
Name:ABOUT BUILDING CONNECTIONS MENTAL HEALTH COUNSELING SERVICES
Entity Type:Organization
Organization Name:ABOUT BUILDING CONNECTIONS MENTAL HEALTH COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KARLI
Authorized Official - Middle Name:
Authorized Official - Last Name:COVERDALE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:631-275-2319
Mailing Address - Street 1:1767 VETERANS HWY STE 24
Mailing Address - Street 2:
Mailing Address - City:ISLANDIA
Mailing Address - State:NY
Mailing Address - Zip Code:11749-1536
Mailing Address - Country:US
Mailing Address - Phone:631-263-8307
Mailing Address - Fax:
Practice Address - Street 1:1767 VETERANS HWY STE 24
Practice Address - Street 2:
Practice Address - City:ISLANDIA
Practice Address - State:NY
Practice Address - Zip Code:11749-1536
Practice Address - Country:US
Practice Address - Phone:631-263-8307
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-21
Last Update Date:2021-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty