Provider Demographics
NPI:1891131827
Name:YMCA COUNSELING SERVICE
Entity Type:Organization
Organization Name:YMCA COUNSELING SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SITE COORDINATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ALANA
Authorized Official - Middle Name:
Authorized Official - Last Name:CARVALHO
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:178-981-4382
Mailing Address - Street 1:285 VANDERBILT AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10304-2525
Mailing Address - Country:US
Mailing Address - Phone:718-981-4382
Mailing Address - Fax:718-981-2054
Practice Address - Street 1:285 VANDERBILT AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10304-2525
Practice Address - Country:US
Practice Address - Phone:178-981-4382
Practice Address - Fax:718-981-2054
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-16
Last Update Date:2013-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center