Provider Demographics
NPI:1770012288
Name:MENTAL HEALTH ASSOCIATION IN NEW YORK STATE, INC.
Entity Type:Organization
Organization Name:MENTAL HEALTH ASSOCIATION IN NEW YORK STATE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:GLENN
Authorized Official - Middle Name:
Authorized Official - Last Name:LIEBMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:518-434-0439
Mailing Address - Street 1:194 WASHINGTON AVE STE 415
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12210-2314
Mailing Address - Country:US
Mailing Address - Phone:518-434-0439
Mailing Address - Fax:
Practice Address - Street 1:194 WASHINGTON AVE STE 415
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12210-2314
Practice Address - Country:US
Practice Address - Phone:518-434-0439
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health