| NPI | 1235737735 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRENDAN STACK Owner, Lpc 518-610-4528 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YP2500X Counselor, Professional | |
| 1041C0700X Social Worker, Clinical | |
| 235Z00000X Speech-Language Pathologist, | |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2020-10-15 |
| Last Update Date | 2025-08-03 |