Provider Demographics
NPI:1205528759
Name:MTZ COUNSELING
Entity type:Organization
Organization Name:MTZ COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:SHAI
Authorized Official - Middle Name:
Authorized Official - Last Name:ERLICHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-823-4459
Mailing Address - Street 1:299 BROADWAY STE 905
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10007-1960
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:299 BROADWAY STE 905
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10007-1960
Practice Address - Country:US
Practice Address - Phone:917-873-1022
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-23
Last Update Date:2023-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health