Smile Psychiatric Nurse Practitioner PC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

SMILE PSYCHIATRIC NURSE PRACTITIONER PC

Practice address

152 Colonial Ave
Williston Park, NY 11596-1527

Phone

(347) 834-1117

NPI assigned

Sep 8, 2021

Organization subpart

No

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

Authorized official

Name

Younjea Lee, NP

Title

Pmhnp/Provider

Phone

(347) 834-1117

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1631059200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1673049600000",
    "number": "1285303792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "152 COLONIAL AVE",
            "city": "WILLISTON PARK",
            "state": "NY",
            "postal_code": "115961527",
            "telephone_number": "347-834-1117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "152 COLONIAL AVE",
            "city": "WILLISTON PARK",
            "state": "NY",
            "postal_code": "115961527",
            "telephone_number": "347-834-1117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMILE PSYCHIATRIC NURSE PRACTITIONER PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-08",
        "last_updated": "2023-01-07",
        "certification_date": "2023-01-07",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "YOUNJEA",
        "authorized_official_title_or_position": "PMHNP/PROVIDER",
        "authorized_official_telephone_number": "347-834-1117",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07374789",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Psychiatric/Mental Health Nurse Practitioner in Williston Park, NY
• Providers in Williston Park, 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 Jan 7, 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.