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General NPI Number Information
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NPI Number | 1649125774
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Entity Type | Organization
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Legal Business Name | KMM MENTAL HEALTH COUNSELING, PLLC
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Dates
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Enumeration Date | 03/03/2026
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Last Update Date | 03/03/2026
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Provider Practice Location Address
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Address Line | 242 MAIN ST # 345
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City | BEACON
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State | NY
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Zip | 12508-2732
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Country | US
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Telephone | 917-740-7592
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Fax |
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Provider Business Mailing Address
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Address Line | 242 MAIN ST # 345
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City | BEACON
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State | NY
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Zip | 12508-2732
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MEMBER-MANAGER
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Name | KAITLIN MASOPUST
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Credential | LMHC
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Telephone | 917-740-7592
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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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