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General NPI Number Information
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NPI Number | 1871704908
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Entity Type | Organization
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Legal Business Name | COUNSELING CARE AND SERVICES INC.
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Dates
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Enumeration Date | 05/24/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 405 VLIET BLVD
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City | COHOES
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State | NY
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Zip | 12047-2019
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Country | US
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Telephone | 518-237-4263
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Fax |
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Provider Business Mailing Address
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Address Line | 63 MCCLEARY AVE
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City | AMSTERDAM
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State | NY
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Zip | 12010-2816
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Country | US
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Telephone | 518-212-2012
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Fax |
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | MRS. MARILYN WHEELER
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Credential | L.M.H.C.,M.S.,C.A.S.
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Telephone | 518-237-4263
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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 | 001562
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License Number State | NY
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