Provider Demographics
NPI: | 1851098776 |
---|---|
Name: | MULTIMODAL MENTAL HEALTH COUNSELING, PLLC |
Entity Type: | Organization |
Organization Name: | MULTIMODAL MENTAL HEALTH COUNSELING, PLLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | MS, LMHC |
Authorized Official - Prefix: | MS |
Authorized Official - First Name: | DANELYS |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | GARCIA |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | MS, LMHC |
Authorized Official - Phone: | 914-575-1305 |
Mailing Address - Street 1: | 131 LARCHMONT AVE |
Mailing Address - Street 2: | |
Mailing Address - City: | LARCHMONT |
Mailing Address - State: | NY |
Mailing Address - Zip Code: | 10538-2804 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 914-575-1305 |
Mailing Address - Fax: | 914-560-2136 |
Practice Address - Street 1: | 131 LARCHMONT AVE |
Practice Address - Street 2: | |
Practice Address - City: | LARCHMONT |
Practice Address - State: | NY |
Practice Address - Zip Code: | 10538-2804 |
Practice Address - Country: | US |
Practice Address - Phone: | 914-575-1305 |
Practice Address - Fax: | 914-560-2136 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2023-02-10 |
Last Update Date: | 2023-02-10 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 101YM0800X | Behavioral Health & Social Service Providers | Counselor | Mental Health | Group - Single Specialty |