Provider Demographics
NPI:1790250876
Name:MENTAL WEALTH PRACTICE, LICENSED MENTAL HEALTH COUNSELING, PLLC
Entity Type:Organization
Organization Name:MENTAL WEALTH PRACTICE, LICENSED MENTAL HEALTH COUNSELING, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANKIE
Authorized Official - Middle Name:
Authorized Official - Last Name:GRIXTI
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:646-820-0018
Mailing Address - Street 1:115 DEHAVEN DR APT 102
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10703-1210
Mailing Address - Country:US
Mailing Address - Phone:914-330-5532
Mailing Address - Fax:
Practice Address - Street 1:280 N CENTRAL AVE STE 450A
Practice Address - Street 2:
Practice Address - City:HARTSDALE
Practice Address - State:NY
Practice Address - Zip Code:10530-1838
Practice Address - Country:US
Practice Address - Phone:646-820-0018
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-04
Last Update Date:2018-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)