Provider Demographics
NPI:1184304339
Name:SYCAMORE HAVEN MENTAL HEALTH COUNSELING, PLLC
Entity type:Organization
Organization Name:SYCAMORE HAVEN MENTAL HEALTH COUNSELING, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPIST, CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:EDILI
Authorized Official - Middle Name:MARLENY
Authorized Official - Last Name:MALDONADO
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC, NCC, CCMHC
Authorized Official - Phone:914-314-5934
Mailing Address - Street 1:481 MAIN ST STE 500A
Mailing Address - Street 2:
Mailing Address - City:NEW ROCHELLE
Mailing Address - State:NY
Mailing Address - Zip Code:10801-6360
Mailing Address - Country:US
Mailing Address - Phone:914-740-3746
Mailing Address - Fax:929-376-2404
Practice Address - Street 1:481 MAIN ST STE 500A
Practice Address - Street 2:
Practice Address - City:NEW ROCHELLE
Practice Address - State:NY
Practice Address - Zip Code:10801-6360
Practice Address - Country:US
Practice Address - Phone:914-740-3746
Practice Address - Fax:929-376-2404
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-21
Last Update Date:2023-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty