Provider Demographics
NPI:1386524114
Name:HYACINTH, JUSTIN (MHC-LP)
Entity type:Individual
Prefix:MR
First Name:JUSTIN
Middle Name:
Last Name:HYACINTH
Suffix:
Gender:M
Credentials:MHC-LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 JAY ST STE 501
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11201-4398
Mailing Address - Country:US
Mailing Address - Phone:347-304-9465
Mailing Address - Fax:
Practice Address - Street 1:203 JAY ST STE 501
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-4398
Practice Address - Country:US
Practice Address - Phone:347-304-9465
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-03
Last Update Date:2025-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY18-P126664-01101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health