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General NPI Number Information
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NPI Number | 1730604257
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Entity Type | Organization
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Legal Business Name | JR MENTAL HEALTH COUNSELING, PLLC
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Dates
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Enumeration Date | 08/04/2017
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Last Update Date | 03/11/2025
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Provider Practice Location Address
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Address Line | 756 MADISON AVE STE 203
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City | ALBANY
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State | NY
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Zip | 12208-3823
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Country | US
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Telephone | 518-545-4896
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 66447
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City | ALBANY
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State | NY
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Zip | 12206-6447
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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 | OWNER/SOLE MEMBER
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Name | JOSHUA RADLIFF
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Credential | LMHC-D
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Telephone | 518-545-4896
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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 | 007396
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License Number State | NY
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