Provider Demographics
NPI:1922879188
Name:AWAKEN MENTAL HEALTH COUNSELING, PLLC
Entity Type:Organization
Organization Name:AWAKEN MENTAL HEALTH COUNSELING, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:BURCU
Authorized Official - Middle Name:
Authorized Official - Last Name:ALTINTAS
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC, LPC
Authorized Official - Phone:631-942-2660
Mailing Address - Street 1:712 EVERDELL AVE
Mailing Address - Street 2:
Mailing Address - City:WEST ISLIP
Mailing Address - State:NY
Mailing Address - Zip Code:11795-3300
Mailing Address - Country:US
Mailing Address - Phone:631-942-2660
Mailing Address - Fax:
Practice Address - Street 1:74 FIRE ISLAND AVE
Practice Address - Street 2:
Practice Address - City:BABYLON
Practice Address - State:NY
Practice Address - Zip Code:11702-3531
Practice Address - Country:US
Practice Address - Phone:631-268-4778
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-15
Last Update Date:2024-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty