Provider Demographics
NPI:1104488469
Name:ALLY MENTAL HEALTH COUNSELING SERVICES
Entity type:Organization
Organization Name:ALLY MENTAL HEALTH COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORGANIZER
Authorized Official - Prefix:
Authorized Official - First Name:NATALY
Authorized Official - Middle Name:
Authorized Official - Last Name:GRULLON
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:347-674-0797
Mailing Address - Street 1:73 MARKET ST STE 376
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10710-7619
Mailing Address - Country:US
Mailing Address - Phone:347-674-0797
Mailing Address - Fax:
Practice Address - Street 1:73 MARKET ST STE 376
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10710-7619
Practice Address - Country:US
Practice Address - Phone:347-674-0797
Practice Address - Fax:347-824-2015
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-07
Last Update Date:2024-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)