Provider Demographics
NPI:1861863086
Name:RECOVERY & WELLNESS MENTAL HEALTH COUNSELING PLLC
Entity Type:Organization
Organization Name:RECOVERY & WELLNESS MENTAL HEALTH COUNSELING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MENTAL HEALTH COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:JOHANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:KORBY
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC, CASAC, SAP
Authorized Official - Phone:845-321-5644
Mailing Address - Street 1:9 RIVER RD
Mailing Address - Street 2:
Mailing Address - City:NEW HAMBURG
Mailing Address - State:NY
Mailing Address - Zip Code:12590-5539
Mailing Address - Country:US
Mailing Address - Phone:845-321-5644
Mailing Address - Fax:845-632-3520
Practice Address - Street 1:3 MARKET ST
Practice Address - Street 2:
Practice Address - City:WAPPINGERS FALLS
Practice Address - State:NY
Practice Address - Zip Code:12590-2301
Practice Address - Country:US
Practice Address - Phone:845-321-5644
Practice Address - Fax:845-632-3520
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-14
Last Update Date:2015-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004770-1101YM0800X
NY073861-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty