Provider Demographics
NPI:1609669563
Name:KIM RAFFAELLI MENTAL HEALTH COUNSELING, PLLC
Entity type:Organization
Organization Name:KIM RAFFAELLI MENTAL HEALTH COUNSELING, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / PSYCHOTHERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:RAFFAELLI
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:845-682-3677
Mailing Address - Street 1:1133 ROUTE 55 STE F
Mailing Address - Street 2:
Mailing Address - City:LAGRANGEVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12540-5057
Mailing Address - Country:US
Mailing Address - Phone:845-682-3677
Mailing Address - Fax:845-748-7016
Practice Address - Street 1:1133 ROUTE 55 STE F
Practice Address - Street 2:
Practice Address - City:LAGRANGEVILLE
Practice Address - State:NY
Practice Address - Zip Code:12540-5057
Practice Address - Country:US
Practice Address - Phone:845-682-3677
Practice Address - Fax:845-748-7016
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-23
Last Update Date:2025-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty