Provider Demographics
NPI:1396333480
Name:OYSTER BAY MENTAL HEALTH COUNSELING PLLC
Entity type:Organization
Organization Name:OYSTER BAY MENTAL HEALTH COUNSELING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:M
Authorized Official - Last Name:CASTRONOVA
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:516-802-5676
Mailing Address - Street 1:97 SINGWORTH ST
Mailing Address - Street 2:
Mailing Address - City:OYSTER BAY
Mailing Address - State:NY
Mailing Address - Zip Code:11771-3705
Mailing Address - Country:US
Mailing Address - Phone:516-802-5676
Mailing Address - Fax:
Practice Address - Street 1:1035 JERICHO OYSTER BAY RD
Practice Address - Street 2:
Practice Address - City:EAST NORWICH
Practice Address - State:NY
Practice Address - Zip Code:11732-1049
Practice Address - Country:US
Practice Address - Phone:516-234-0541
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-05
Last Update Date:2021-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)