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General NPI Number Information
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NPI Number | 1790250876
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Entity Type | Organization
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Legal Business Name | MENTAL WEALTH PRACTICE, LICENSED MENTAL HEALTH COUNSELING, PLLC
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Dates
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Enumeration Date | 10/04/2018
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Last Update Date | 10/14/2018
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Provider Practice Location Address
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Address Line | 280 N CENTRAL AVE STE 450A
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City | HARTSDALE
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State | NY
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Zip | 10530-1838
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Country | US
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Telephone | 646-820-0018
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Fax |
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Provider Business Mailing Address
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Address Line | 115 DEHAVEN DR APT 102
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City | YONKERS
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State | NY
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Zip | 10703-1210
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Country | US
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Telephone | 914-330-5532
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Fax |
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Authorized Official
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Title or Position | OWNER / THERAPIST
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Name | MR. FRANKIE GRIXTI
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Credential | LMHC
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Telephone | 646-820-0018
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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