NPIMap

Organization Active NPI

MN Psychological Services PLLC

  • Psychologist
  • Brooklyn, NY
National Provider Identifier
1003381708
Registry record updated Aug 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
MN PSYCHOLOGICAL SERVICES PLLC
Practice address
2255 Cropsey Ave
Brooklyn, NY 11214-5705
Phone
(718) 221-5800
NPI assigned
Oct 9, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2024

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

Authorized official

Name
Michael NuccitelliNPI 1740303940
Title
Member
Phone
(718) 221-5800

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X Primary

Addresses

Primary practice location

2255 Cropsey Ave
Brooklyn, NY 11214-5705

Mailing address

5705 Foster Ave
Brooklyn, NY 11234-1001
Phone (718) 221-5800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20181220002077 NY Part B Supplier - Clinic/Group Practice 5294070165 Receives reassigned benefits from 7 practitioners
Practice locations: Far Rockaway, NY; Rockaway Beach, NY; Hempstead, NY; Brooklyn, NY; Brookhaven, NY

National Provider Directory

National Provider Directory
Tax ID family
MN Psychological Services PLLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1539043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723161600000",
    "number": "1003381708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5705 FOSTER AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112341001",
            "telephone_number": "718-221-5800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2255 CROPSEY AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112145705",
            "telephone_number": "718-221-5800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MN PSYCHOLOGICAL SERVICES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-09",
        "last_updated": "2024-08-09",
        "certification_date": "2024-08-09",
        "status": "A",
        "authorized_official_last_name": "NUCCITELLI",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "718-221-5800"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.