Provider Demographics
NPI:1902369655
Name:SHAKER MENTAL HEALTH COUNSELING, P.C.
Entity Type:Organization
Organization Name:SHAKER MENTAL HEALTH COUNSELING, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:CALIENDO
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:845-706-3861
Mailing Address - Street 1:201 N PEARL ST
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12207-2309
Mailing Address - Country:US
Mailing Address - Phone:845-706-3861
Mailing Address - Fax:518-452-4233
Practice Address - Street 1:201 N PEARL ST
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12207-2309
Practice Address - Country:US
Practice Address - Phone:845-706-3861
Practice Address - Fax:518-452-4233
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-10
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)