Healthcare Provider Details

I. General information

NPI: 1639016082
Provider Name (Legal Business Name): NEW YORK MENTAL HEALTH COUNSELING SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2026
Last Update Date: 05/04/2026
Certification Date: 05/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11632 130TH ST
SOUTH OZONE PARK NY
11420-2604
US

IV. Provider business mailing address

11632 130TH ST
SOUTH OZONE PARK NY
11420-2604
US

V. Phone/Fax

Practice location:
  • Phone: 917-981-0276
  • Fax:
Mailing address:
  • Phone: 917-981-0276
  • 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: MRS. WENDY M MEZA
Title or Position: OWNER
Credential: LMHC
Phone: 917-981-0276