Organization
HCSVS MENTAL HEALTH TELEMEDICINE STARTUP PBC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAURENCE GIRARD (CHAIRMAN)
(347) 515-2417
Entity
Organization
Contact information
Practice address
702 HOUSTON ST, FORT WORTH, TX 76102-5004
(347) 515-2417
Mailing address
1125 GARDEN ST, HOBOKEN, NJ 07030-4304
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103TC1900X
Counseling Psychologist
Primary
—
—
Other
Enumeration date
05/06/2025
Last updated
05/06/2025
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