Provider Demographics
NPI:1639281173
Name:THE PSYCHOTHERAPY CENTER FOR PERSONAL GROWTH, FAMILY ENHANCEMENT & REC
Entity Type:Organization
Organization Name:THE PSYCHOTHERAPY CENTER FOR PERSONAL GROWTH, FAMILY ENHANCEMENT & REC
Other - Org Name:THE CENTER FOR PERSONAL DEVELOPMENT & RECOVERY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:PARISI
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:845-294-6114
Mailing Address - Street 1:2002 ROUTE 17M
Mailing Address - Street 2:SUITE 10
Mailing Address - City:GOSHEN
Mailing Address - State:NY
Mailing Address - Zip Code:10924-5235
Mailing Address - Country:US
Mailing Address - Phone:845-294-6114
Mailing Address - Fax:845-294-4139
Practice Address - Street 1:2002 ROUTE 17M
Practice Address - Street 2:SUITE 10
Practice Address - City:GOSHEN
Practice Address - State:NY
Practice Address - Zip Code:10924-5235
Practice Address - Country:US
Practice Address - Phone:845-294-6114
Practice Address - Fax:845-294-4139
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPRO15715-1101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty