Organization
PENINSULA COUNSELING CENTER,INC
Active
Other names
Outpatient Mental Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JACQUELINE RIVERA-HERRERA (VP OF FINANCE FOR CLINICAL SERVICES)
(347) 542-4217
Entity
Organization
Contact information
Practice address
50 W. HAWTHORNE AVENUE, VALLEY STREAM, NY 11580
(516) 569-6600
(516) 374-2261
Mailing address
142-02 20TH AVENUE, 3RD FLOOR, FLUSHING, NY 11351
(718) 559-0555
(718) 445-7111
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00244817
—
NY
Enumeration date
08/17/2006
Last updated
03/04/2015
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