Provider Demographics
NPI:1740046788
Name:ALDEN MENTAL HEALTH COUNSELING WELLNESS, PLLC
Entity type:Organization
Organization Name:ALDEN MENTAL HEALTH COUNSELING WELLNESS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/LICENSED MENTAL HEALTH COUNSE
Authorized Official - Prefix:
Authorized Official - First Name:ERIN
Authorized Official - Middle Name:
Authorized Official - Last Name:RUSTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-937-3300
Mailing Address - Street 1:11901 BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:ALDEN
Mailing Address - State:NY
Mailing Address - Zip Code:14004-9454
Mailing Address - Country:US
Mailing Address - Phone:716-937-3300
Mailing Address - Fax:
Practice Address - Street 1:11901 BROADWAY ST
Practice Address - Street 2:
Practice Address - City:ALDEN
Practice Address - State:NY
Practice Address - Zip Code:14004-9454
Practice Address - Country:US
Practice Address - Phone:716-937-3300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-27
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty