| Brooklyn Healthy Mind 360- Nurse Practitioner In Psychiatry Pllc | |
|
26 Court St Ste 409 Brooklyn NY 11242-1134 | |
| (347) 450-1294 | |
| Not Available |
| Full Name | Brooklyn Healthy Mind 360- Nurse Practitioner In Psychiatry Pllc |
|---|---|
| Speciality | Social Worker |
| Location | 26 Court St Ste 409, Brooklyn, New York |
| Authorized Official Name and Position | Kellie Carey (CREDENTIALING MANAGER) |
| Authorized Official Contact | 5167298606 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Brooklyn Healthy Mind 360- Nurse Practitioner In Psychiatry Pllc 26 Court St Ste 409 Brooklyn NY 11242-1134 Ph: (347) 450-1294 | Brooklyn Healthy Mind 360- Nurse Practitioner In Psychiatry Pllc 26 Court St Ste 409 Brooklyn NY 11242-1134 Ph: (347) 450-1294 |
| NPI Number | 1932706413 |
|---|---|
| Provider Enumeration Date | 10/07/2020 |
| Last Update Date | 10/07/2020 |
| Certification Date | 10/07/2020 |
| Medicare PECOS PAC ID | 3971908674 |
|---|---|
| Medicare Enrollment ID | O20210818002311 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932706413 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Wendy Mcintosh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376092346 PECOS PAC ID: 4880099589 Enrollment ID: I20210818002834 |
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