# EXPERIENTIAL MENTAL HEALTH COUNSELING LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1770061509
- **Authorized official:** MR. GREGORY REID LMHC (DIRECTOR)
- **Authorized official phone:** (518) 945-8828

## Contact information

- **Practice address:** 120 DEFREEST DR STE 220, TROY, NY 12180-7608
- **Practice address phone:** (518) 945-8828
- **Mailing address:** 120 DEFREEST DR STE 220, TROY, NY 12180-7608
- **Mailing address phone:** (518) 945-8828

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | 008111 | NY | Yes |

## Other

- **Enumeration date:** 08/02/2018
- **Last updated:** 08/02/2018