Provider Demographics
NPI:1932631801
Name:ALQUIMEDEZ MENTAL HEALTH COUNSELING
Entity Type:Organization
Organization Name:ALQUIMEDEZ MENTAL HEALTH COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:HENRY
Authorized Official - Middle Name:A
Authorized Official - Last Name:MONTERO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:315-533-0453
Mailing Address - Street 1:2248 BROADWAY STE 1329
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-5805
Mailing Address - Country:US
Mailing Address - Phone:315-610-6675
Mailing Address - Fax:914-505-2458
Practice Address - Street 1:246 W 80TH ST
Practice Address - Street 2:FL 4 STE 15
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024
Practice Address - Country:US
Practice Address - Phone:315-505-2400
Practice Address - Fax:914-505-2458
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-30
Last Update Date:2023-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0054041101YA0400X, 261QM0850X, 261QM0855X
101YM0800X
NY1926172084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental HealthGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1932631801OtherNPI
NY01635529Medicaid