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General NPI Number Information
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NPI Number | 1124875372
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Entity Type | Organization
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Legal Business Name | FAB MENTAL HEALTH COUNSELING PLLC
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Dates
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Enumeration Date | 05/06/2024
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Last Update Date | 05/27/2024
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Provider Practice Location Address
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Address Line | 3 E EVERGREEN RD
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City | NEW CITY
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State | NY
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Zip | 10956-5145
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Country | US
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Telephone | 845-818-6286
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Fax |
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Provider Business Mailing Address
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Address Line | 3 E EVERGREEN RD
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City | NEW CITY
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State | NY
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Zip | 10956-5145
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Country | US
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Telephone | 845-533-2421
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | MRS. FRANCINE BAILEY
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Credential | LMHC
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Telephone | 845-936-7207
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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