Healthcare Provider Details

I. General information

NPI: 1740081165
Provider Name (Legal Business Name): OWLS NEST MENTAL HEALTH COUNSELING, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/21/2025
Last Update Date: 05/10/2025
Certification Date: 05/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

891 STATE HIGHWAY 162
SPRAKERS NY
12166-4503
US

IV. Provider business mailing address

891 STATE HIGHWAY 162
SPRAKERS NY
12166-4503
US

V. Phone/Fax

Practice location:
  • Phone: 518-898-7712
  • Fax:
Mailing address:
  • Phone: 518-898-7712
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL A BETTS
Title or Position: DIRECTOR OR MENTAL HEALTH SERVICES
Credential: LMHC
Phone: 518-898-7712