Provider Demographics
NPI:1447961800
Name:NAZARETH COUNSELING COMPANY, LLC
Entity type:Organization
Organization Name:NAZARETH COUNSELING COMPANY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:J
Authorized Official - Last Name:WINLEY
Authorized Official - Suffix:
Authorized Official - Credentials:MA, NCC, LMHC
Authorized Official - Phone:646-719-1229
Mailing Address - Street 1:547 W 147TH ST
Mailing Address - Street 2:SUITE F2
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10031-4445
Mailing Address - Country:US
Mailing Address - Phone:646-719-1229
Mailing Address - Fax:
Practice Address - Street 1:547 W 147TH ST SUITE F2
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10031-4445
Practice Address - Country:US
Practice Address - Phone:646-719-1229
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-07
Last Update Date:2022-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health