| NPI | 1750033304 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER SULLIVAN Chief Operations Officer 267-237-7014 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical |
| 104100000X Social Worker | |
| 103T00000X Psychologist | |
| 103TC2200X Psychologist, Clinical Child & Adolescent | |
| 1041C0700X Social Worker, Clinical | |
| 101YP2500X Counselor, Professional | |
| 106H00000X Marriage & Family Therapist | |
| Enumeration Date | 2022-01-25 |
| Last Update Date | 2026-01-08 |