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General NPI Number Information
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NPI Number | 1902031107
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Entity Type | Organization
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Legal Business Name | THELMA A COSTELLO MS LMHC PC
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Dates
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Enumeration Date | 05/18/2009
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Last Update Date | 01/01/2025
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Provider Practice Location Address
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Address Line | 3 COMPUTER DR W STE 116
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City | ALBANY
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State | NY
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Zip | 12205-1621
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Country | US
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Telephone | 518-495-7531
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Fax | 518-207-1900
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Provider Business Mailing Address
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Address Line | 3 COMPUTER DR W STE 116
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City | ALBANY
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State | NY
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Zip | 12205-1621
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Country | US
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Telephone | 518-495-7531
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Fax | 518-207-1900
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Authorized Official
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Title or Position | PSYCHOTHERAPIST
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Name | THELMA A COSTELLO
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Credential | LMHC
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Telephone | 518-438-3139
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 000145-1
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License Number State | NY
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