National Provider Identifier
Lockport Mental Health Counseling
Lockport Mental Health Counseling is listed in the NPPES registry with a primary specialty of Mental Health Counselor in Tonawanda, NY and a listed phone number of (716) 418-3885.
Source: public NPPES record, last updated July 30, 2024. This profile is informational and is not medical advice, a quality rating, or a provider recommendation.
Profile Overview
- NPI
- 1922863174
- Provider Type
- Organization
- Primary Specialty
- Mental Health Counselor
- Enumeration Date
- February 16, 2024
- Last Updated
- July 30, 2024
Practice Location
- 1868 Niagara Falls Blvd Ste 308
- Tonawanda, NY 14150-6494
Phone: (716) 418-3885
Authorized Official
- Name
- Mrs. Isaiah Mantooth-Jordan
- Title
- Owner
- Credentials
- LMHC
- Phone
- (716) 418-3885
Specialties
- Mental Health Counselor (101YM0800X)
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Full Record
- NPI
- 1922863174
- Entity Type
- Organization
- EIN
- <UNAVAIL>
- Organization Name
- Lockport Mental Health Counseling
- Other Organization Name
- <Unavail>
- Provider Other Organization Name Type Code
- 6
- Mailing Street Address
- 1868 Niagara Falls Blvd Ste 308
- Mailing City
- Tonawanda
- Mailing State
- NY
- Mailing ZIP Code
- 14150-6494
- Mailing Country
- US
- Mailing Phone
- (716) 418-3885
- Practice Street Address
- 1868 Niagara Falls Blvd Ste 308
- Practice City
- Tonawanda
- Practice State
- NY
- Practice ZIP Code
- 14150-6494
- Practice Country
- US
- Practice Phone
- (716) 418-3885
- Enumeration Date
- February 16, 2024
- Last Updated
- July 30, 2024
- Authorized Official Last Name
- Mantooth-Jordan
- Authorized Official First Name
- Isaiah
- Authorized Official Title
- Owner
- Authorized Official Phone
- (716) 418-3885
- Organization Subpart
- No
- Authorized Official Name Prefix Text
- Mrs.
- Authorized Official Credential Text
- LMHC
- Taxonomy Group 1
- 193400000X Single Specialty Group
- Certification Date
- July 30, 2024
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Mental Health Counselor (101YM0800X)