NPIMap

Organization Active NPI

Whole Self Collective

  • Psychologist
  • Brooklyn, NY
National Provider Identifier
1154019032
Registry record updated Apr 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
WHOLE SELF COLLECTIVE
Practice address
275 14TH St
Brooklyn, NY 11215-4911
Phone
(347) 456-7731
NPI assigned
Apr 27, 2023
Last updated
Apr 27, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2023

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

Authorized official

Name
Jacqueline PhungNPI 1831283779
Title
Manager/Owner
Phone
(347) 456-7731

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: 193400000X SINGLE SPECIALTY GROUP 103T00000X Primary

Addresses

Primary practice location

275 14TH St
Brooklyn, NY 11215-4911

Mailing address

PO Box 150-424
Brooklyn, NY 11215

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1682553600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682553600000",
    "number": "1154019032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 150-424",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 14TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112154911",
            "telephone_number": "347-456-7731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WHOLE SELF COLLECTIVE",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-27",
        "last_updated": "2023-04-27",
        "certification_date": "2023-04-27",
        "status": "A",
        "authorized_official_last_name": "PHUNG",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_title_or_position": "MANAGER/OWNER",
        "authorized_official_telephone_number": "347-456-7731"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE 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 Apr 27, 2023; 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.