Healthcare Provider Details

I. General information

NPI: 1104726884
Provider Name (Legal Business Name): TINK MENTAL HEALTH COUNSELING PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/06/2026
Last Update Date: 11/06/2026
Certification Date: 11/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

982 MAIN ST STE 4-172
FISHKILL NY
12524-3506
US

IV. Provider business mailing address

982 MAIN ST STE 4-172
FISHKILL NY
12524-3506
US

V. Phone/Fax

Practice location:
  • Phone: 845-516-9280
  • Fax:
Mailing address:
  • Phone: 845-516-9280
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: MARY MARGARET MADDOX
Title or Position: MEMBER-MANAGER
Credential: LMHC
Phone: 845-516-9280