Provider Demographics
NPI:1750112231
Name:CONSCIOUS MIND PSYCHOTHERAPY
Entity type:Organization
Organization Name:CONSCIOUS MIND PSYCHOTHERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRIVATE PRACTICE OWNER
Authorized Official - Prefix:
Authorized Official - First Name:IREM
Authorized Official - Middle Name:
Authorized Official - Last Name:FRANCO
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:516-499-2887
Mailing Address - Street 1:PO BOX 497
Mailing Address - Street 2:
Mailing Address - City:DEER PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11729-0497
Mailing Address - Country:US
Mailing Address - Phone:631-954-2287
Mailing Address - Fax:516-951-1135
Practice Address - Street 1:375 CARLLS PATH UNIT 497
Practice Address - Street 2:
Practice Address - City:DEER PARK
Practice Address - State:NY
Practice Address - Zip Code:11729-7826
Practice Address - Country:US
Practice Address - Phone:631-954-2287
Practice Address - Fax:516-951-1135
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-08
Last Update Date:2024-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty