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General NPI Number Information
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NPI Number | 1912788258
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Entity Type | Organization
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Legal Business Name | CNY TRUE NORTH MENTAL HEALTH COUNSELING, PLLC
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Dates
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Enumeration Date | 10/12/2023
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Last Update Date | 10/12/2023
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Provider Practice Location Address
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Address Line | 662 S MAIN ST STE 3
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City | CENTRAL SQUARE
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State | NY
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Zip | 13036-3534
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Country | US
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Telephone | 757-646-5861
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 274
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City | CENTRAL SQUARE
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State | NY
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Zip | 13036-0274
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Country | US
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Telephone | 757-646-5861
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MELANIE HUSS
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Credential | LMHC
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Telephone | 757-646-5861
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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