Provider Demographics
NPI: | 1740089481 |
---|---|
Name: | BEAUTIFUL MINDS MENTAL HEALTH COUNSELING, PLLC |
Entity type: | Organization |
Organization Name: | BEAUTIFUL MINDS MENTAL HEALTH COUNSELING, PLLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | FOUNDER/OWNER |
Authorized Official - Prefix: | |
Authorized Official - First Name: | CHRISTINA |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | DEBIANCHI |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | LMHC-D, LPC, ACS |
Authorized Official - Phone: | 347-210-1350 |
Mailing Address - Street 1: | 139 GURLEY AVE |
Mailing Address - Street 2: | |
Mailing Address - City: | STATEN ISLAND |
Mailing Address - State: | NY |
Mailing Address - Zip Code: | 10308-1614 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 347-210-1350 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 139 GURLEY AVE |
Practice Address - Street 2: | |
Practice Address - City: | STATEN ISLAND |
Practice Address - State: | NY |
Practice Address - Zip Code: | 10308-1614 |
Practice Address - Country: | US |
Practice Address - Phone: | 347-210-1350 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2025-03-12 |
Last Update Date: | 2025-03-17 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 101YM0800X | Behavioral Health & Social Service Providers | Counselor | Mental Health | Group - Multi-Specialty |