Provider Demographics
NPI:1760152649
Name:COUNSELING CENTER OF NEW YORK
Entity Type:Organization
Organization Name:COUNSELING CENTER OF NEW YORK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ALEXIS
Authorized Official - Middle Name:
Authorized Official - Last Name:SANTIAGO-AUTAR
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:914-217-4555
Mailing Address - Street 1:600 MAMARONECK AVE STE 400
Mailing Address - Street 2:
Mailing Address - City:HARRISON
Mailing Address - State:NY
Mailing Address - Zip Code:10528-1613
Mailing Address - Country:US
Mailing Address - Phone:914-217-4555
Mailing Address - Fax:
Practice Address - Street 1:600 MAMARONECK AVE STE 400
Practice Address - Street 2:
Practice Address - City:HARRISON
Practice Address - State:NY
Practice Address - Zip Code:10528-1613
Practice Address - Country:US
Practice Address - Phone:914-217-4555
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-14
Last Update Date:2021-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)