Provider Demographics
NPI:1821641234
Name:MIND WORKS NYC MENTAL HEALTH COUNSELING P C
Entity Type:Organization
Organization Name:MIND WORKS NYC MENTAL HEALTH COUNSELING P C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ANDREE
Authorized Official - Middle Name:
Authorized Official - Last Name:DECASTRO
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:347-403-3420
Mailing Address - Street 1:6904 224TH ST
Mailing Address - Street 2:
Mailing Address - City:OAKLAND GARDENS
Mailing Address - State:NY
Mailing Address - Zip Code:11364-3028
Mailing Address - Country:US
Mailing Address - Phone:917-714-6412
Mailing Address - Fax:
Practice Address - Street 1:1214 31ST AVE # CF
Practice Address - Street 2:
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11106-4833
Practice Address - Country:US
Practice Address - Phone:347-403-3420
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-24
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1497210611Other1497210611