Provider Demographics
NPI:1063176766
Name:JURCZYNSKI, MICHELLE (LMHC)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:JURCZYNSKI
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:
Other - Last Name:KOSTSZEWSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMHC
Mailing Address - Street 1:40 N MAIN AVE
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12203-1481
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:40 N MAIN AVE
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12203-1481
Practice Address - Country:US
Practice Address - Phone:518-453-6700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-28
Last Update Date:2025-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
NYP104571-01101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health