Provider Demographics
NPI:1386337111
Name:REGO PARK COUNSELING LLC
Entity type:Organization
Organization Name:REGO PARK COUNSELING LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:EMANUIL
Authorized Official - Middle Name:
Authorized Official - Last Name:KALENDAREV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-496-3834
Mailing Address - Street 1:6336 99TH ST
Mailing Address - Street 2:
Mailing Address - City:REGO PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11374-1979
Mailing Address - Country:US
Mailing Address - Phone:718-459-2558
Mailing Address - Fax:718-770-7676
Practice Address - Street 1:6336 99TH ST
Practice Address - Street 2:
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374-1979
Practice Address - Country:US
Practice Address - Phone:718-459-2558
Practice Address - Fax:718-770-7676
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-29
Last Update Date:2023-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health