OrganizationClub Mental Health Counseling Services, P.C.CounselorBehavioral Health & Social Service ProvidersPractice Address272 Ada Dr, Staten Island, NY 10314-1434(718) 873-3189(781) 873-3189PECOS EnrollmentBased on the most recent information from CMS, provider Club Mental Health Counseling Services, P.C. does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 1:08 PM.Profile DetailsProvider ID1982912929Provider TypeOrganizationFull NameClub Mental Health Counseling Services, P.C.SubpartNoEnumeration Date9/23/2010Last Updated9/23/2010Contact InformationPractice LocationPractice Address272 Ada Dr, Staten Island, NY 10314-1434Phone(718) 873-3189Fax(718) 982-8508Mailing LocationMailing AddressPO Box 140695, Staten Island, NY 10314-0695Phone(781) 873-3189Fax(718) 982-8508Authorized OfficialNameMartin, Leslie B (President)Phone(718) 873-3189Provider TaxonomiesCodeDescriptionLicenseCode101YM0800XPrimaryDescriptionCounselorBehavioral Health & Social Service ProvidersLicense001024-1New York