Divine Mental Health Treatment

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

DIVINE MENTAL HEALTH TREATMENT

Practice address

27 Carpenter Ave Ste 7
Middletown, NY 10940-2401

Phone

(452) 388-8538

Fax

(646) 619-4083

NPI assigned

Jan 27, 2021

Organization subpart

No

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

Authorized official

Name

Dr. Debra Mayers, NURSE PRACTITIONER

Title

Psychiatric Nurse Practitioner

Phone

(845) 238-8853

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Divine Mental Health Treatment Doing business as

Electronic endpoints 1

Locations

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

{
    "created_epoch": "1611705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1648166400000",
    "number": "1053902569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27 CARPENTER AVE STE 7",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "109402401",
            "telephone_number": "845-238-8853",
            "fax_number": "646-619-4083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27 CARPENTER AVE STE 7",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "109402401",
            "telephone_number": "452-388-8538",
            "fax_number": "646-619-4083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVINE MENTAL HEALTH TREATMENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-27",
        "last_updated": "2022-03-25",
        "certification_date": "2022-03-25",
        "status": "A",
        "authorized_official_last_name": "MAYERS",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_title_or_position": "PSYCHIATRIC NURSE PRACTITIONER",
        "authorized_official_telephone_number": "845-238-8853",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "NURSE PRACTITIONER"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04672304",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Middletown",
            "affiliation": "N",
            "endpointDescription": "Middletown",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "Middletown",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Middletown",
            "address_1": "27 Carpenter Ave Ste 7",
            "city": "Middletown",
            "state": "NY",
            "country_code": "US",
            "postal_code": "109402401",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Divine Mental Health Treatment",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Divine Mental Health Treatment",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Psychiatric/Mental Health Nurse Practitioner in Middletown, NY
• Providers in Middletown, NY by specialty
• Psychiatric/Mental Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2022; 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.