MLW Developmental Evaluation Center

Primary specialty

Early Intervention Provider AgencyTaxonomy code 252Y00000X

Legal business name

MLW DEVELOPMENTAL EVALUATION CENTER

Practice address

215 Bassett St
Syracuse, NY 13210-2113

Phone

(315) 472-4404

NPI assigned

Oct 17, 2012

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Caroll Grant, PHD

Title

Director/School Psychologist

Phone

(315) 472-4404

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1350432000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350432000000",
    "number": "1003169988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 BASSETT ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132102113",
            "telephone_number": "315-472-4404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 BASSETT ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132102113",
            "telephone_number": "315-472-4404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MLW DEVELOPMENTAL EVALUATION CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-17",
        "last_updated": "2012-10-17",
        "status": "A",
        "authorized_official_last_name": "GRANT",
        "authorized_official_first_name": "CAROLL",
        "authorized_official_title_or_position": "DIRECTOR/SCHOOL PSYCHOLOGIST",
        "authorized_official_telephone_number": "315-472-4404",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachel Renee Mitchell, PH.D.
• Sterling Lamont Mitchell, LPN
• Kaitlin Brianna Mitts
• Luke Mitzel, PHD
• Michael Mix, MD
• Haris Mobeen, MD
• Mobile NP-Adult Health of Cny, P.C.
• Mobility Products Corp
• Robin Lynn Mock, MA
• Raasisree Modalavalasa

• Early Intervention Provider Agency in Syracuse, NY
• Providers in Syracuse, NY by specialty
• Early Intervention Provider Agency in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.