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NPI Code Detail

MEDICARE: MIND WORKS NYC MENTAL HEALTH COUNSELING P C

MEDICARE: MIND WORKS NYC MENTAL HEALTH COUNSELING P C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11497210611OTHERNY1497210611

General Provider Information

NPI Number : 1821641234
Entity Type Code : Organization
Provider Name (Legal Business Name) : MIND WORKS NYC MENTAL HEALTH COUNSELING P C
Provider Business Mailing Address
First Line : 6904 224TH ST
Second Line :
City : OAKLAND GARDENS
State : NY
Zip : 11364-3028
Country : US
Telephone Number : 917-714-6412
Fax Number :
Provider Business Practice Location Address
First Line : 1214 31ST AVE # CF
Second Line :
City : ASTORIA
State : NY
Zip : 11106-4833
Country : US
Telephone Number : 347-403-3420
Fax Number :
Authorized Official
Title or Position : CEO
Name : ANDREE DECASTRO
Credential : LMHC
Telephone Number : 347-403-3420
Provider Enumeration Date : 07/24/2019
Last Update Date : 02/28/2024

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