Provider Demographics
NPI:1861180069
Name:NICOLE M. SERINI LMHC PLLC
Entity type:Organization
Organization Name:NICOLE M. SERINI LMHC PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:SERINI
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:845-705-4790
Mailing Address - Street 1:37A BELL DR
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND
Mailing Address - State:NY
Mailing Address - Zip Code:12528-1607
Mailing Address - Country:US
Mailing Address - Phone:845-705-4790
Mailing Address - Fax:
Practice Address - Street 1:1334 RT 9W
Practice Address - Street 2:
Practice Address - City:MARLBORO
Practice Address - State:NY
Practice Address - Zip Code:12542-1252
Practice Address - Country:US
Practice Address - Phone:845-705-4790
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-26
Last Update Date:2023-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty