MIND, BODY & SPIRIT MARRIAGE AND FAMILY THERAPY (NPI# 1134789563) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134789563 |
| Entity Type | Organization |
| Organization Name | MIND, BODY & SPIRIT MARRIAGE AND FAMILY THERAPY |
| Practice Address |
825 Northway St Syracuse NY 13224-1322 |
| Mailing Address |
Po Box 186 Syracuse NY 13201-0186 |
| Practice Telephone | 3152431083 |
| Mailing Telephone | 3152431083 |
| Enumeration Date | 2019-06-18 |
| Last Update Date | 2020-06-26 |
| Authorized Official Name | RHEA PARKS (OWNER) |
| Authorized Official Telephone | 3152431083 |
| Authorized Official Credential | MFT-LP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 106H00000X | Marriage & Family Therapist | Behavioral Health & Social Service Providers |
| Street Address |
825 NORTHWAY ST |
| City | SYRACUSE |
| State | NY |
| Zip Code | 13224-1322 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598329534 | Judie Lyn Gordon-louison | Registered Nurse | 2429 East Fayette Street, Syracuse, Syracuse, NY 13224 | 2019-04-25 |
| 1669942363 | Julie E. Clonan | Speech-Language Pathologist | 3049 E. Genesee St., Syracuse, NY 13224 | 2018-11-26 |
| 1043604762 | Heather Lynn Blum | Licensed Practical Nurse | 120 Niven Street, Syracuse, NY 13224 | 2015-03-19 |
| 1912226523 | Florence Delisi | Licensed Practical Nurse | 2315 East Fayette St, Syracuse, NY 13224 | 2010-05-21 |
| 1336476563 | Kimberlee Anne Difulio | Licensed Practical Nurse | 1615 Meadowbrook Drive, #3, Syracuse, NY 13224 | 2009-11-09 |
| 1134371081 | Amy Lynn Ezekiel | Speech-Language Pathologist | 3049 East Genesee Street, Syracuse, NY 13224 | 2008-10-22 |
| 1104951490 | Daniel Stephen Delluomo | Dentist | 3175 East Genesee St, Suite 2, Syracuse, NY 13224 | 2007-02-23 |
| 1447317037 | Fumiyo Hirano | Social Worker | 182 Edgehill Road, Syracuse, NY 13224 | 2007-01-02 |
| 1295811198 | Mark A Matloff | Psychologist | 409 Standish Drive, Syracuse, NY 13224 | 2006-10-31 |
| 1235222530 | Bernadine Alese Martin | Dentist | 1125 Salt Springs Road, Syracuse, NY 13224 | 2006-10-02 |
| Find all providers in zip 13224 | ||||
| Taxonomy Code | 106H00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Marriage & Family Therapist |
| A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134752454 | Crystal Elizabeth Hoban | Marriage & Family Therapist | 4922 W. Seneca Turnpike, Syracuse, NY 13215 | 2020-02-14 |
| 1891327540 | Ashley Kessler | Marriage & Family Therapist | 2122 Erie Blvd E Ste C, Syracuse, NY 13224-1041 | 2020-02-11 |
| 1275193641 | Jennifer Whang | Marriage & Family Therapist | 677 S Salina St, Syracuse, NY 13202-3535 | 2019-06-18 |
| 1801453147 | Kaylea Dineen | Marriage & Family Therapist | 677 S Salina St Ste 200, Syracuse, NY 13202-3513 | 2019-05-22 |
| 1821583436 | Jacqueline Amanda Weiner | Marriage & Family Therapist | 3532 James Street, Syracuse, NY 13206 | 2018-06-26 |
| 1083107106 | Georgia Hicks | Marriage & Family Therapist | 414 Hawley Ave # 2, Syracuse, NY 13203-2410 | 2018-06-13 |
| 1356893903 | Donna Dallal-ferne | Marriage & Family Therapist | 312 Hampshire Dr, Syracuse, NY 13214-1507 | 2016-10-31 |
| 1992162705 | Breyanna Marie Locke | Marriage & Family Therapist | 50 Presidential Plz Ste Ll4, Syracuse, NY 13202-2229 | 2016-01-25 |
| 1639568967 | Roberto De Giorgio | Marriage & Family Therapist | 1723 W 1375 S, Syracuse, UT 84075-6951 | 2015-01-09 |
| 1346653391 | Michele Anne Welch | Marriage & Family Therapist | 405 Oak St Fl 2, Syracuse, NY 13203-2938 | 2014-06-07 |
| Find all providers in SYRACUSE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.