Mercy Haven Inc

Primary specialty

Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X

License

01304012 Issued in NY

Legal business name

MERCY HAVEN INC

Practice address

859 Connetquot Ave Ste 10
Islip Terrace, NY 11752-1400

Phone

(631) 277-8300

Fax

(631) 277-8394

NPI assigned

Feb 28, 2007

Organization subpart

No

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

Authorized official

Name

Patricia Griffith, D.MIN.,LMSW

Title

Executive Director

Phone

(631) 277-8300

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 2

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

• Jenelle Moran, LCSW

  • Clinical Social Worker
  • Islip Terrace, NY
  • NPI 1023259561
  NPD (past)
• Donna O'Hearon, LMSW

  • Social Worker
  • Islip Terrace, NY
  • NPI 1366143158
  NPD (past)

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

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1285762716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "859 CONNETQUOT AVE STE 10",
            "city": "ISLIP TERRACE",
            "state": "NY",
            "postal_code": "117521400",
            "telephone_number": "631-277-8300",
            "fax_number": "631-277-8394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "859 CONNETQUOT AVE STE 10",
            "city": "ISLIP TERRACE",
            "state": "NY",
            "postal_code": "117521400",
            "telephone_number": "631-277-8300",
            "fax_number": "631-277-8394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCY HAVEN INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GRIFFITH",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "631-277-8300",
        "authorized_official_credential": "D.MIN.,LMSW"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "NY",
            "license": "01304012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01304012",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ingemar Manarin Mapanao, PT
• Julee Ann Marazzito
• Margaret M. Magee, R.N., L.M.T., PLLC
• Mary McGrory
• Caroline Louise McNeill
• Lisa Ann Miller
• Dominica Milton
• Maria A. Modica, RN
• Elizabeth Mohammed
• Nidhin Mohan, R.PH

• Mental Illness Community Based Residential Treatment Facility in Islip Terrace, NY
• Providers in Islip Terrace, NY by specialty
• Mental Illness Community Based Residential Treatment Facility in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.