Envision Behavioral and Mental Health LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

ENVISION BEHAVIORAL AND MENTAL HEALTH LLC

Practice address

450 Waverly Ave
BLDG. 3, Suite 11
Patchogue, NY 11772-1555

Phone

(631) 307-9892

NPI assigned

Mar 31, 2021

Organization subpart

No

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

Authorized official

Name

Shahzad Zeb

Title

President

Phone

(631) 307-9892

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1617148800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617148800000",
    "number": "1083292973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 WAVERLY AVE",
            "address_2": "BLDG. 2 SUITE 1",
            "city": "PATCHOGUE",
            "state": "NY",
            "postal_code": "11772",
            "telephone_number": "631-307-9892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 WAVERLY AVE",
            "address_2": "BLDG. 3, SUITE 11",
            "city": "PATCHOGUE",
            "state": "NY",
            "postal_code": "117721555",
            "telephone_number": "631-307-9892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENVISION BEHAVIORAL AND MENTAL HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-31",
        "last_updated": "2021-03-31",
        "certification_date": "2021-03-31",
        "status": "A",
        "authorized_official_last_name": "ZEB",
        "authorized_official_first_name": "SHAHZAD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "631-307-9892"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Patchogue, NY
• Providers in Patchogue, NY by specialty
• Mental Health Counselor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2021; 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.