NPIMap

Organization Active NPI

Park Ave. Psychotherapy Group

  • Clinical Social Worker
  • Rockaway Park, NY
National Provider Identifier
1376891291
Registry record updated Aug 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R027402 Issued in NY
Legal business name
PARK AVE. PSYCHOTHERAPY GROUP
Practice address
167 Beach 135
Rockaway Park, NY 11694-1303
Phone
(718) 634-0253
Fax
(718) 634-1056
NPI assigned
Aug 27, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2012

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

Authorized official

Name
Ms. Andrea Rhonda Gitter, M.A.,B.C.D.T.R.
Title
Director
Phone
(718) 634-0253

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X R027402 NY Primary

Addresses

Primary practice location

167 Beach 135
Rockaway Park, NY 11694-1303

Mailing address

167 Beach 135
Rockaway Park, NY 11694-1303
Phone (718) 634-0253

Other identifiers 1

IdentifierTypeStateIssuer
R027402OtherNYNYS LIC.

Other names 1

  • NY GROUP FOR PSYCHOTHERAPIES Former legal business name

National Provider Directory

National Provider Directory
Tax ID family
Ny Group for Psychotherapies2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

NPI Registry JSON

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

{
    "created_epoch": "1346025600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1346025600000",
    "number": "1376891291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "167 BEACH 135",
            "city": "ROCKAWAY PARK",
            "state": "NY",
            "postal_code": "116941303",
            "telephone_number": "718-634-0253",
            "fax_number": "718-634-1056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "167 BEACH 135",
            "city": "ROCKAWAY PARK",
            "state": "NY",
            "postal_code": "116941303",
            "telephone_number": "718-634-0253",
            "fax_number": "718-634-1056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARK AVE. PSYCHOTHERAPY GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-27",
        "last_updated": "2012-08-27",
        "status": "A",
        "authorized_official_last_name": "GITTER",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_middle_name": "RHONDA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "718-634-0253",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "M.A.,B.C.D.T.R."
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R027402",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NYS LIC.",
            "identifier": "R027402",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NY GROUP FOR PSYCHOTHERAPIES",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Rockaway Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2012; 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.