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Staten Island Mental Health Counseling Pllc

Counselor

Behavioral Health & Social Service Providers

2285 Victory Blvd, Staten Island, NY 10314-6625

PECOS Enrollment

Based on the most recent information from CMS, provider Staten Island Mental Health Counseling Pllc does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records yesterday at 1:08 PM.

Profile Details

Provider ID
1902381064
Provider Type
Organization
Full Name
Staten Island Mental Health Counseling Pllc

Subpart
No
Enumeration Date
9/25/2018
Last Updated
9/25/2018

Contact Information

Practice Location

2285 Victory Blvd, Staten Island, NY 10314-6625

(917) 273-3119

Unlisted Fax

Mailing Location

2285 Victory Blvd, Staten Island, NY 10314-6625

(917) 273-3119

Unlisted Fax

Authorized Official

Giuliano, Christina (Lmhc/Owner)

(917) 273-3119

Provider Taxonomies

Code	Description	License
Code 101YM0800X Primary	Description Counselor Behavioral Health & Social Service Providers	License Unlisted Issuer

Staten Island Mental Health Counseling Pllc

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Authorized Official

Provider Taxonomies

Code

Description

License

Code

Description

License

Mental Health Counseling Of Staten Island Pc

Defoe, Radie

Harris, Lisa M

Ng, Christopher

Muntasser, Fadwa

Gorsky, Kelly I

Fuentes-Murillo, Johanna

Peck, Jane

Doors To Freedom Mental Health Counseling Services, Pllc

Moseley, Tamara