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General NPI Number Information
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NPI Number | 1437773611
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Entity Type | Organization
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Legal Business Name | COLLABORATIVE THERAPY MENTAL HEALTH COUNSELING PC
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Dates
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Enumeration Date | 06/03/2020
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Last Update Date | 02/06/2025
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Provider Practice Location Address
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Address Line | 136 MADISON AVE FL 5
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City | NEW YORK
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State | NY
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Zip | 10016-6796
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Country | US
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Telephone | 929-280-3994
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Fax | 929-419-9061
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Provider Business Mailing Address
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Address Line | 136 MADISON AVE FL 5
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City | NEW YORK
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State | NY
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Zip | 10016-6796
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Country | US
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Telephone | 929-280-3994
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Fax | 929-419-9061
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Authorized Official
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Title or Position | FOUNDER & LMHC
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Name | KYLE WILLIAM MCEVOY
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Credential | LMHC
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Telephone | 631-682-7741
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 102L00000X
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Taxonomy Name | Psychoanalyst
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License Number |
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License Number State |
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Taxonomy #5
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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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