Provider Demographics
NPI:1588438451
Name:AUTHENTICALLY WHOLE MENTAL HEALTH COUNSELING, PLLC
Entity type:Organization
Organization Name:AUTHENTICALLY WHOLE MENTAL HEALTH COUNSELING, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DENIZ
Authorized Official - Middle Name:N
Authorized Official - Last Name:DEGIRMENCI
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:718-775-7468
Mailing Address - Street 1:382 ONTARIO ST
Mailing Address - Street 2:
Mailing Address - City:LOCKPORT
Mailing Address - State:NY
Mailing Address - Zip Code:14094-2033
Mailing Address - Country:US
Mailing Address - Phone:718-775-7468
Mailing Address - Fax:
Practice Address - Street 1:1 MAIN ST STE 5
Practice Address - Street 2:
Practice Address - City:LOCKPORT
Practice Address - State:NY
Practice Address - Zip Code:14094-3606
Practice Address - Country:US
Practice Address - Phone:716-944-6136
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-13
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Single Specialty