Provider Demographics
NPI:1407671639
Name:MB MENTAL HEALTH COUNSELING, PLLC
Entity type:Organization
Organization Name:MB MENTAL HEALTH COUNSELING, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LMHC
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:BOYD
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:508-415-0190
Mailing Address - Street 1:1060 BROADWAY # 50721
Mailing Address - Street 2:
Mailing Address - City:MENANDS
Mailing Address - State:NY
Mailing Address - Zip Code:12204-2507
Mailing Address - Country:US
Mailing Address - Phone:508-415-0190
Mailing Address - Fax:
Practice Address - Street 1:2543 BARTON AVE
Practice Address - Street 2:
Practice Address - City:SCHENECTADY
Practice Address - State:NY
Practice Address - Zip Code:12306-4307
Practice Address - Country:US
Practice Address - Phone:508-415-0190
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-21
Last Update Date:2024-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)