NPIMap

Organization Active NPI

Groundwork Therapy Psychological Services, PLLC

  • Clinical Psychologist
  • Brooklyn, NY
National Provider Identifier
1205328010
Registry record updated Dec 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
GROUNDWORK THERAPY PSYCHOLOGICAL SERVICES, PLLC
Practice address
1000 Dean Street,
Suite 226
Brooklyn, NY 11238
Phone
(347) 669-9792
NPI assigned
Jun 6, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2018

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

Authorized official

Name
Melissa Morgan Johnson, PSYDNPI 1093048753
Title
Owner/Member/Clinical Psychologist
Phone
(714) 267-0471

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
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X Primary

Addresses

Primary practice location

1000 Dean Street,
Suite 226
Brooklyn, NY 11238

Mailing address

1000 Dean Street,
Suite 226
Brooklyn, NY 11238
Phone (347) 669-9792

Other identifiers 2

IdentifierTypeStateIssuer
1013167907OtherNPI
1093048753OtherNPI

Other names 1

  • Groundwork Therapy, PLLC Former legal business name

National Provider Directory

National Provider Directory

Locations

1000 Dean St
Ste 226
Brooklyn, NY 11238
Phone (347) 669-9792

Practitioners & affiliated clinicians

Practitioners 7

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": "1528243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1545350400000",
    "number": "1205328010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 DEAN STREET,",
            "address_2": "SUITE 226",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11238",
            "telephone_number": "347-669-9792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 DEAN STREET,",
            "address_2": "SUITE 226",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11238",
            "telephone_number": "347-669-9792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GROUNDWORK THERAPY PSYCHOLOGICAL SERVICES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-06",
        "last_updated": "2018-12-21",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_middle_name": "MORGAN",
        "authorized_official_title_or_position": "OWNER/MEMBER/CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "714-267-0471",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1013167907",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1093048753",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Groundwork Therapy, PLLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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 Dec 21, 2018; 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.