Provider Demographics
NPI:1124871785
Name:STREAM OF CONSCIOUSNESS MENTAL HEALTH COUNSELING PLLC
Entity type:Organization
Organization Name:STREAM OF CONSCIOUSNESS MENTAL HEALTH COUNSELING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:NEILIE
Authorized Official - Middle Name:
Authorized Official - Last Name:CORDINER
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:518-796-8974
Mailing Address - Street 1:50 MOUNTAIN RD
Mailing Address - Street 2:
Mailing Address - City:GANSEVOORT
Mailing Address - State:NY
Mailing Address - Zip Code:12831-1022
Mailing Address - Country:US
Mailing Address - Phone:518-796-8974
Mailing Address - Fax:
Practice Address - Street 1:50 MOUNTAIN RD
Practice Address - Street 2:
Practice Address - City:GANSEVOORT
Practice Address - State:NY
Practice Address - Zip Code:12831-1022
Practice Address - Country:US
Practice Address - Phone:518-796-8974
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-11
Last Update Date:2024-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1730762774OtherNPI