| Organization Name: | MOHAWK VALLEY COUNSELING SERVICE |
| NPI Number: | 1487993796 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MARK A. LUNDQUIST (OWNER) |
| Mailing Address: | 178 2nd St Ste 2 Ilion |
| State: | NY US |
| Postal Code: | 133572038 |
| Phone Number: | 3158688610 |
| Fax Number: | 3158672004 |
| NPI Enumeration Date: | 02/06/2013 |
| NPI Last Update Date: | 02/06/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | R042820-1 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |