Provider Demographics
NPI:1184078354
Name:PERSONALIZED COUNSELING SERVICES
Entity type:Organization
Organization Name:PERSONALIZED COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:ARDINGER-MATEO
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:914-737-4331
Mailing Address - Street 1:87 HEMLOCK CIR
Mailing Address - Street 2:
Mailing Address - City:PEEKSKILL
Mailing Address - State:NY
Mailing Address - Zip Code:10566-4966
Mailing Address - Country:US
Mailing Address - Phone:914-737-4331
Mailing Address - Fax:
Practice Address - Street 1:87 HEMLOCK CIR
Practice Address - Street 2:
Practice Address - City:PEEKSKILL
Practice Address - State:NY
Practice Address - Zip Code:10566-4966
Practice Address - Country:US
Practice Address - Phone:914-737-4331
Practice Address - Fax:914-737-4331
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-14
Last Update Date:2016-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
R0257751041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty