Organization
ADVANCED CENTER FOR PSYCHOTHERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FRANK MESTECKS (ACCOUNTS MANAGER)
(718) 206-6821
Entity
Organization
Contact information
Practice address
178-10 WEXFORD TERRACE, JAMAICA ESTATES, NY 11432
(718) 658-1123
(718) 658-7091
Mailing address
PO BOX 9161, UNIONDALE, NY 11555-9161
(631) 391-7794
(631) 454-4164
Taxonomy
Speciality
Code
Description
License number
State
103TP2701X
Group Psychotherapy Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00245836
—
NY
Enumeration date
06/06/2007
Last updated
08/22/2020
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