NPIMap

Organization Active NPI

Mental Health Providers of Western Queens

  • Community/Behavioral Health Agency
  • Jackson Heights, NY
National Provider Identifier
1104200294
Registry record updated Jul 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
094706 Issued in NY
Legal business name
MENTAL HEALTH PROVIDERS OF WESTERN QUEENS
Practice address
3708 91St St
Suite 3a
Jackson Heights, NY 11372-7928
Phone
(718) 779-2263
Fax
(718) 779-2225
NPI assigned
Jul 17, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2015

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

Authorized official

Name
Katherine Laing Ambia, LMSWNPI 1427520154
Title
Clinician
Phone
(917) 566-3754

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
Community/Behavioral Health Agency 251S00000X 094706 NY Primary

Addresses

Primary practice location

3708 91St St
Suite 3a
Jackson Heights, NY 11372-7928

Mailing address

213 Taaffe PL
Apt. 214
Brooklyn, NY 11205-4378
Phone (917) 566-3754

Other identifiers 1

IdentifierTypeStateIssuer
094706OtherNYLMSW LICENSE NUMBER

National Provider Directory

National Provider Directory
Tax ID family
Mental Health Providers of Western Queens Inc4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

3708 91st St
Ste 3A
Jackson Heights, NY 11372
Phone (718) 779-2263

Practitioners & affiliated clinicians

Practitioners 39

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

View all 39

NPI Registry JSON

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

{
    "created_epoch": "1437091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1437091200000",
    "number": "1104200294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "213 TAAFFE PL",
            "address_2": "APT. 214",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112054378",
            "telephone_number": "917-566-3754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3708 91ST ST",
            "address_2": "SUITE 3A",
            "city": "JACKSON HEIGHTS",
            "state": "NY",
            "postal_code": "113727928",
            "telephone_number": "718-779-2263",
            "fax_number": "718-779-2225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MENTAL HEALTH PROVIDERS OF WESTERN QUEENS",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-17",
        "last_updated": "2015-07-17",
        "status": "A",
        "authorized_official_last_name": "AMBIA",
        "authorized_official_first_name": "KATHERINE",
        "authorized_official_middle_name": "LAING",
        "authorized_official_title_or_position": "CLINICIAN",
        "authorized_official_telephone_number": "917-566-3754",
        "authorized_official_credential": "LMSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NY",
            "license": "094706",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LMSW LICENSE NUMBER",
            "identifier": "094706",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson Heights, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2015; 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.