Organization
MENDING HEARTS COUNSELING INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL KRUGOLETS (OPERATIONS MANAGER)
(718) 813-9924
Entity
Organization
Contact information
Practice address
1975 LINDEN BLVD, ELMONT, NY 11003-4025
(516) 751-4020
Mailing address
115 GRAHAM BLVD, STATEN ISLAND, NY 10305-4005
(718) 813-9924
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103TC0700X
Clinical Psychologist
—
—
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
—
—
2084P0800X
Psychiatry Physician
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Enumeration date
10/28/2024
Last updated
10/28/2024
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