| Northside Psychology Pllc | |
|
331 Leonard St Ste 1f Brooklyn NY 11211-2309 | |
| (718) 669-1919 | |
| (347) 308-5985 |
| Full Name | Northside Psychology Pllc |
|---|---|
| Speciality | Psychologist |
| Location | 331 Leonard St Ste 1f, Brooklyn, New York |
| Authorized Official Name and Position | David Mahony (CLINICAL PSYCHOLOGIST) |
| Authorized Official Contact | 7186681919 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Northside Psychology Pllc 331 Leonard St Ste 1f Brooklyn NY 11211-2309 Ph: (718) 669-1919 | Northside Psychology Pllc 331 Leonard St Ste 1f Brooklyn NY 11211-2309 Ph: (718) 669-1919 |
| NPI Number | 1477058998 |
|---|---|
| Provider Enumeration Date | 03/27/2018 |
| Last Update Date | 03/27/2018 |
| Medicare PECOS PAC ID | 5193117570 |
|---|---|
| Medicare Enrollment ID | O20220114000655 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477058998 | NPI | - | NPPES |
| 01947837 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 013606 (New York) | Primary |
| Provider Name | David Mahony |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1649226069 PECOS PAC ID: 1052376894 Enrollment ID: I20041122000463 |
| Provider Name | Debra K Smith |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1720089972 PECOS PAC ID: 3375565799 Enrollment ID: I20051229000363 |
| Provider Name | Brian Kelly |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1235494774 PECOS PAC ID: 7315189800 Enrollment ID: I20130813000509 |
| Provider Name | Gregory Mack |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1669523106 PECOS PAC ID: 3971899782 Enrollment ID: I20160902001557 |
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