Psychotherapy And Mental Wellness Group Practice, PLLC
Clinic/Center, Mental Health (Including Community Mental Health Center) in Brooklyn, NY. Organization (NPI-2).
NPI number1669043196
StatusActive
Last updated in NPPESJul 6, 2021
Details
- NPI
- 1669043196
- Entity type
- Organization (NPI-2)
- Legal business name
- Psychotherapy And Mental Wellness Group Practice, PLLC
- Organization subpart
- No
- Enumeration date
- Jul 6, 2021
- Certification date
- Jul 6, 2021
- Last updated
- Jul 6, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QM0801X | Clinic/Center, Mental Health (Including Community Mental Health Center) | – | – | Yes |
| 261QM0850X | Clinic/Center, Adult Mental Health | – | – | |
| 261QM0855X | Clinic/Center, Adolescent and Children Mental Health | – | – |
Practice location
10 Saint Pauls Pl Apt 1lBrooklyn, NY 11226-1363
Phone 213-373-4484
Mailing address
10 Saint Pauls Pl Apt 1lBrooklyn, NY 11226-1363
Phone 213-373-4484
Authorized official
Melissa Boudin
Licensed Psychologist/Clinical Dir
2133734484
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